Lymphadenectomy Does Not Improve Cancer-Specific Survival for Colorectal Cancer Patients Underwent Endoscopic Therapy: A Population-Based Retrospective Study
Background: The effect of lymph node resection after endoscopic treatment of malignant polyps is controversial. Therefore, in this study, we aimed to estimate the potential cancer-specific survival (CSS) benefits of lymphadenectomy in patients undergoing endoscopic resection for colorectal cancer (C...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2025.2484540 |
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| Summary: | Background: The effect of lymph node resection after endoscopic treatment of malignant polyps is controversial. Therefore, in this study, we aimed to estimate the potential cancer-specific survival (CSS) benefits of lymphadenectomy in patients undergoing endoscopic resection for colorectal cancer (CRC).Methods A total of 6626 patients with CRC who were initially referred for endoscopic polypectomy were enrolled from the Surveillance Epidemiology and End Results Database.Results: Most enrolled patients (6557/6626, 99.0%) were at T0–T1 stage (American Joint Committee on Cancer staging system). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to reduce selection bias, which resulted in balanced groups of patients with and without lymphadenectomy, with no difference in CSS (p = .99 and .074, respectively). In the subgroup analysis, insufficient lymphadenectomy (lymph node yield [LNY] < 12) was associated with poor CSS compared with no lymphadenectomy. The multivariate analysis identified adequate lymphadenectomy with an LNY ≥ 12 as an independent favorable prognostic factor. However, nearly half of the patients (59/127, 46.5%) referred for lymph node resection did not undergo adequate lymphadenectomy.Conclusions The prognosis of CSS cannot be improved by lymphadenectomy for most patients (T0–T1) who are referred for endoscopic therapy because of the low rate of lymph node metastasis. Nonetheless, adequate lymphadenectomy should be performed instead of diagnostic lymph node resection if lymph node involvement is suspected. |
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| ISSN: | 0894-1939 1521-0553 |