Topic Highlight
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2015; 21(43): 12218-12233
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12218
Stage migration vs immunology: The lymph node count story in colon cancer
Bruno Märkl
Bruno Märkl, Institute of Pathology, Klinikum Augsburg, 86156 Augsburg, Germany
Author contributions: Märkl B contributed to this paper.
Conflict-of-interest statement: The author has no competing commercial, personal, political, intellectual, or religious interests in relation to the submitted work to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Bruno Märkl, Privatdozent, Institute of Pathology, Klinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany.
Telephone: +49-821-4003199 Fax: +49-821-400173199
Received: May 14, 2015
Peer-review started: May 15, 2015
First decision: July 14, 2015
Revised: September 1, 2015
Accepted: October 23, 2015
Article in press: October 26, 2015
Published online: November 21, 2015
Core Tip

Core tip: The number of evaluated lymph nodes is prognostic in stage II and III colon cancers. Understaging due to inadequate lymph node harvest causing a stage migration effect is a widely accepted explanation for this. However, there is growing evidence that understaging plays only a minor role in this context. It seems much more likely that immune response has influence on the lymph nodes’ detectability and is associated with outcome in colon cancer.