Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2016; 8(3): 179-192
Published online Mar 27, 2016. doi: 10.4240/wjgs.v8.i3.179
Assessment of lymph node involvement in colorectal cancer
Mark L H Ong, John B Schofield
Mark L H Ong, John B Schofield, Department of Histopathology, Maidstone Hospital, Maidstone, Kent ME16 9QQ, United Kingdom
John B Schofield, School of Physical Sciences, University of Kent, Canterbury, Kent CT2 7NH, United Kingdom
Author contributions: Ong MLH and Schofield JB wrote and amended the paper.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
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: John Schofield, MBBS, Professor, Consultant Histopathologist, Department of Histopathology, Maidstone Hospital, Hermitage Lane, Maidstone, Kent ME16 9QQ, United Kingdom.
Telephone: +44-16-22224050 Fax: +44-16-22225774
Received: August 8, 2015
Peer-review started: August 11, 2015
First decision: September 22, 2015
Revised: October 24, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: March 27, 2016
Core Tip

Core tip: The number of lymph nodes in surgical resection specimens is influenced by numerous factors. Good practice by surgeons and pathologists is essential to maximize lymph node yields, but there are non-modifiable factors related to patient and tumour. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision, all increase lymph node yields, but a definite benefit in prognosis is not proven and the optimal extent of surgical resection remains contentious. Conversely, further development in sentinel lymph node biopsy techniques could allow selective lymphadenectomy, whilst providing appropriate information to guide adjuvant therapy.