Lymph node size as a predictor of lymphatic staging in colonic cancer. BJS 2014; 101: 701-706.

Results

Metastases were found in 99 of 2043 measured lymph nodes in 150 patients. Lymph nodes smaller than 3 mm were positive in 8·0 per cent of patients (12 of 150), but were the sole reason for upstaging in only 1·3 per cent (2 of 150). No metastases were found among 95 nodes of 1 mm or less. Metastatic nodes were larger than those without metastasis (median (i.q.r.) 5·0 (3·2–7·0) versus 3·8 (2·4–5·2) mm; P < 0·001), but a receiver operating characteristic (ROC) curve did not identify a relevant cut‐off point to predict metastatic involvement. A hazard ratio of 0·71 (95 per cent confidence interval 0·50 to 1·01) was suggestive of an association between disease recurrence and increased node size, although not significant (P = 0·056). In patients with N0 disease, there was a correlation between node size and harvest (Pearson's correlation 0·317, P = 0·002), and a nodal yield of at least 12 was associated with a larger median node size (4·3 (3·3–5·0) versus 3·4 (2·7–4·0) mm; P = 0·015).