The relati̇onshi̇p between the resected colon length and the Lymph nodes in colorectal cancers

Objective: Malignant lymph nodes numbers in patients with colorectal cancer and enough of these lymph nodes resection is very important on survival. In this study, it is aimed to investigate whether there is a relationship between resected colon length and the number of lymph nodes which have been operated patients caused by colorectal cancers. Materials and Methods: A retrospective study was performed to determine the relationship between the number of lymph nodes and the lengths of the colon specimens obtained from 531 patients who underwent colorectal surgery between January 01, 2010 and June 20, 2018 at the Gaziantep University, Şahinbey Training and Research Hospital, Department of General Surgery. In this study, parameters such as age, gender, total lymph node, benign lymph node, malignant lymph node, lymph node ratio, colon and rectum length were examined. Findings: Of the 531 patients included in the study, 219 (%41,2) were female and 312 (%58,8) were male. 100 (%66,7) of the patients with benign diagnosis were male and 50 (%33,3) were female. Of the patients diagnosed with malignancy, 212 (%55,6) were male and 169 (%44,4) were female. The mean age of all patients was 55.85; the youngest patient was 17 years old and the oldest patient was 92 years old. The mean age of the patients with benign diagnosis was 50,67±19,23; The mean age of the patients diagnosed with malignancy was 57,90±14,45. According to the pathology report of 531 patients, 150 (28.2) were benign; 381 (%71.8) are malignant. Of the 381 patients, 337 were diagnosed with adenocarcinoma. The mean colon specimen length was found to be 30.24 cm in patients with benign diagnosis and VII 26.68 cm in patients with malignant diagnosis. The mean number of lymph nodes was 10.43 in patients with benign diagnoses; it was found to be 28.96 in patients with malignant diagnosis. The probability of 5 years overall Survival is 53.2%; The average life span was 49,87±1,82 months. The probability of 5 years survival due to disease is 58.2% the average life expectancy was 54,38±1,79 months. There is a direct correlation between colon length and total lymph node and reactive lymph node, and its correlation is poor.There is an inverse relationship between colon length and malignant lymph node and its correlation is very weak. There is a direct proportion between colon length and total with reactive lypmph nodes;but correlation is weak.There is an inverse ratio between colon length and the malignant lymph node number; but correlation is very weak. In our study, hazard ratio was determined by using cox regression analysis for the parameters effecting the disease specific survival. It has been found that the 1 unit change in the lymph node ratio increases hazard ratio by 10,28 times, and that the number of 1 node increase in the number of malignant lymph nodes increases hazard ratio by 1,099 times. Reactive lymph node increased 1 unit, hazard ratio was found to reduce by %2. Result: There is a significant relationship between the length of the colon and the number of total and benign lymph nodes in patients who underwent surgery for colorectal cancer. No significant relationship was found with the number of malignant lymph nodes. Enough colonic specimen length to obtain the minimum number of lymph nodes required for proper staging of the disease is required. An increase in the number of malignant lymph nodes reduces the survival and has a negative effect on prognosis.