Preoperative lymph-node enlargement is associated with favorable survival for patients with pathological stage II colorectal cancer
4 affiliations
- 1Department of Surgery, Fujisawa City Hospital, Fujisawa, Japan
- 2Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama-shi, 232-0024 Japan
- 3Department of Gastroenterological Surgery, Yokohama City University Graduate school of Medicine, Yokohama, Japan
- 4Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
Abstract
Purpose: The importance of preoperative lymph-node enlargement as a prognostic factor for patients with colorectal cancer remains unclear because of inconsistent staging and size criteria. We conducted this study to evaluate its clinical impact, using a standardized definition for pathological stage II colorectal cancer.
Methods: The subjects of this retrospective study were patients with pathological stage II colorectal adenocarcinoma, who underwent curative resection between January 2009 and December 2020. Patients were categorized based on preoperative lymph-node enlargement, defined as a short-axis diameter ≥5 mm on imaging. Independent risk factors for 5-year overall survival (OS) and relapse-free survival (RFS) were investigated.
Results: A total of 562 patients were included (185 without and 377 with enlarged lymph nodes), and the median follow-up period was 61.8 months. Multivariate analysis identified that preoperative hemoglobin level < 12 g/dL (hazard ratios (HRs) = 1.937, 95% confidence interval (CI) = 1.181–3.175, p = 0.009) and preoperative bowel obstruction (hazard ratios (HRs) = 2.060, 95% confidence interval (CI) = 1.066–3.979, p = 0.031) were independent factors for poor OS. Conversely, lymph node enlargement was independently associated with favorable OS (HRs = 0.503, 95% CI, 0.316–0.801, p = 0.004). Pathological T4 stage was an independent factor for poor RFS (HRs = 2.973, 95% CI = 1.752–5.044, p < 0.001).
Conclusions: Preoperative lymph-node enlargement predicts favorable OS for patients with pathological stage II colorectal cancer.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03440-8.
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BibTeX
@article{ota2026preoperative,
title = {{Preoperative lymph-node enlargement is associated with favorable survival for patients with pathological stage II colorectal cancer}},
author = {Emi Ota and Mayumi Ozawa and Shigeru Yamagishi and Kazuya Nakagawa and Koichi Mori and Kanechika Den and Hirokazu Suwa and Itaru Endo},
journal = {Surgery Today},
year = {2026},
month = aug,
doi = {10.1007/s00595-026-03440-8},
url = {https://doi.org/10.1007/s00595-026-03440-8},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Preoperative lymph-node enlargement is associated with favorable survival for patients with pathological stage II colorectal cancer
AU - Emi Ota
AU - Mayumi Ozawa
AU - Shigeru Yamagishi
AU - Kazuya Nakagawa
AU - Koichi Mori
AU - Kanechika Den
AU - Hirokazu Suwa
AU - Itaru Endo
PY - 2026
DA - 2026/08/12
JO - Surgery Today
DO - 10.1007/s00595-026-03440-8
UR - https://doi.org/10.1007/s00595-026-03440-8
AB - Purpose: The importance of preoperative lymph-node enlargement as a prognostic factor for patients with colorectal cancer remains unclear because of inconsistent staging and size criteria. We conducted this study to evaluate its clinical impact, using a standardized definition for pathological stage II colorectal cancer. Methods: The subjects of this retrospective study were patients with pathological stage II colorectal adenocarcinoma, who underwent curative resection between January 2009 and December 2020. Patients were categorized based on preoperative lymph-node enlargement, defined as a short-axis diameter ≥5 mm on imaging. Independent risk factors for 5-year overall survival (OS) and relapse-free survival (RFS) were investigated. Results: A total of 562 patients were included (185 without and 377 with enlarged lymph nodes), and the median follow-up period was 61.8 months. Multivariate analysis identified that preoperative hemoglobin level < 12 g/dL (hazard ratios (HRs) = 1.937, 95% confidence interval (CI) = 1.181–3.175, p = 0.009) and preoperative bowel obstruction (hazard ratios (HRs) = 2.060, 95% confidence interval (CI) = 1.066–3.979, p = 0.031) were independent factors for poor OS. Conversely, lymph node enlargement was independently associated with favorable OS (HRs = 0.503, 95% CI, 0.316–0.801, p = 0.004). Pathological T4 stage was an independent factor for poor RFS (HRs = 2.973, 95% CI = 1.752–5.044, p < 0.001). Conclusions: Preoperative lymph-node enlargement predicts favorable OS for patients with pathological stage II colorectal cancer. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03440-8.
SN - 0941-1291
SN - 1436-2813
ER -