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E-Poster Display

410P - Extent of lymph node (LN) resection and tumour sidedness in operable colon cancer (CC) stage and survival


17 Sep 2020


E-Poster Display


Tumour Site

Colon and Rectal Cancer


Pedro Simões


Annals of Oncology (2020) 31 (suppl_4): S409-S461. 10.1016/annonc/annonc270


P. Simões1, A. Faria1, G. Fernandes2, C. Baptista1, B. Costeira3, L. Leal-Costa1, J. Godinho1, J. Moreira-Pinto1, C. Gomes4, J. Correia2, J. Albuquerque2, T. Padrão2, D. Albergaria3, H. Oliveira5, L. Mascarenhas-Lemos6, M. Casa-Nova1, J.A. Teixeira1, C. Pulido2, R. Maio3, J.L. Passos-Coelho1

Author affiliations

  • 1 Medical Oncology Department, Hospital Beatriz Angelo-Loures, 2674-514 - Loures/PT
  • 2 Medical Oncology Department, Hospital da Luz Lisboa, 1500-650 - Lisboa/PT
  • 3 Surgery Department, Hospital Beatriz Angelo-Loures, 2674-514 - Loures/PT
  • 4 Gastroenterology Department, Hospital Beatriz Angelo-Loures, 2674-514 - Loures/PT
  • 5 Pathology Department, Hospital Beatriz Angelo-Loures, 2674-514 - Loures/PT
  • 6 Pathology Department, Hospital da Luz Lisboa, 1500-650 - Lisboa/PT


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Abstract 410P


Guidelines recommend regional lymphadenectomy with at least 12 assessed lymph nodes (LN) for adequate colon cancer (CC) staging. Recent data suggest that the worse survival of right-sided CC can be mitigated by harvesting more than 22 LN. We studied the impact of lymphadenectomy yield and tumour side on CC staging and survival.


This is a Portuguese, multicentre, retrospective cohort study. All patients (pts) with stage I-III CC that underwent surgical resection from 2012 to 2018 were included and grouped according to LN yield: <12, 12-21 and ≥22. Primary outcomes were LN-positivity (N+) rate and overall survival (OS), with disease-free survival (DFS) as a secondary outcome. Similar exploratory analysis was done by tumour sidedness (right CC, up to the splenic flexure, vs left CC). Standard univariate and multivariate analyses were performed w/ binomial logistic regression models for assessing the independent impact of the LN yield on N+ rate, and standard survival analysis for OS and DFS.


808 pts (mean age 69.6 yo, 54% male, 53% left-sided CC) were included, 95 with <12, 323 with 12-21 and 390 with ≥22 resected LN; 29% with stage I, 37% stage II and 34% stage III CC. 38% were treated with adjuvant chemotherapy (CT), the majority with a platinum doublet (68%). Pts in the ≥22 LN group were younger (P=0.03), had more right-sided tumours and stage III CC (P<0.0001); in addition compared to pts with <12 LN, they had higher levels of lymphovascular invasion (LVI) and treatment with adjuvant CT (P=0.01). There was a nonsignificant likelihood of N+ tumours in univariate logistic regression in the ≥22 LN group (OR 1.33, P=0.07), which remained nonsignificant after adjusting for T stage and LVI. With a median follow-up of 43 months, there was no difference on univariate analysis in OS or DFS between the 3 groups (log rank test P=0.47 and P=0.67, respectively). In multivariate analysis, adjusting for age, T and N stage, laparoscopic vs open approach and adjuvant CT, pts with ≥22 resected LN had longer OS compared to the other groups (HR 0.724, 95%CI 0.526-0.998), but not DFS. There was no interaction between CC sidedness and LN group on either N+ status, OS or DFS.


Resection of ≥22 LN was associated with longer OS but not with higher odds of N+ staging in pts with operable CC, independently of tumour sidedness.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


P. Simões: Travel/Accommodation/Expenses: Sanofi; Travel/Accommodation/Expenses: Vifor Pharma / OM Pharma; Travel/Accommodation/Expenses: Amgen; Travel/Accommodation/Expenses: Merck; Travel/Accommodation/Expenses: TESARO; Travel/Accommodation/Expenses: Roche; Travel/Accommodation/Expenses: Janssen; Travel/Accommodation/Expenses: Ipsen. A. Faria: Honoraria (self): Roche; Honoraria (self): Astellas; Honoraria (self): Laboratórios Vitória. G. Fernandes: Honoraria (self): Janssen; Honoraria (self): Astellas; Honoraria (self), Travel/Accommodation/Expenses: Vifor Pharma / OM Pharma; Travel/Accommodation/Expenses: Novartis; Travel/Accommodation/Expenses: Sanofi; Travel/Accommodation/Expenses: Servier; Travel/Accommodation/Expenses: BMS; Travel/Accommodation/Expenses: Ipsen; Travel/Accommodation/Expenses: Pierre Fabre. J. Godinho: Advisory/Consultancy: Grunenthal. J. Moreira-Pinto: Research grant/Funding (self): Roche; Travel/Accommodation/Expenses: Janssen; Travel/Accommodation/Expenses: Servier; Travel/Accommodation/Expenses: BMS. M. Casa-Nova: Advisory/Consultancy: Roche; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Merck; Honoraria (self): AstraZeneca; Honoraria (self): Tesaro; Honoraria (self): Novartis. J.A. Teixeira: Advisory/Consultancy: Janssen; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Ipsen; Advisory/Consultancy: Roche. C. Pulido: Honoraria (self): AstraZeneca; Honoraria (self): Grunenthal; Honoraria (self): Novartis. J.L. Passos-Coelho: Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Roche; Advisory/Consultancy, Research grant/Funding (self): Novartis; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Lilly; Travel/Accommodation/Expenses: Janssen. All other authors have declared no conflicts of interest.

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