EP765 - Lymph Node Resection in Colon Cancer: Is 12 the Magic Number?

Monday, May 11, 2026

8:27 AM - 8:32 AM ET

ePoster Presenter(s)

TM

Threshia Malcolm, MD

Fellow
LSU
New Orleans, Louisiana, United States

Disclosure information not submitted.

Author(s)

AH

Arman E. Haveric, BS

Medical Student
Lewis Katz School of Medicine at Temple University
Philadelphia, Pennsylvania, United States

Disclosure information not submitted.
DY

Daohai Yu, PhD

Professor
Temple University
Philadelphia, Pennsylvania, United States

Disclosure information not submitted.
AS

An SUN, MS

Statistical Programmer
Lewis Katz School of Medicine at Temple University
Philadelphia, Pennsylvania, United States

Disclosure information not submitted.
GS

GODA SAVULIONYTE, MD

Colorectal Surgeon
Temple University
Philadelphia, Pennsylvania, United States

Disclosure information not submitted.
JV

Joceline Vu

Disclosure information not submitted.

Senior Author(s)

Juan Lucas Poggio, MD, MS, FASCRS (he/him/his)

Professor of Surgery. Chief Division of Colorectal Surgery and System Chief of Colorectal Surgery
Temple Health System
Lewis Katz Medical School Temple University
Philadlephia, PA, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Juan Lucas Poggio, MD, MS, FASCRS: This individual has no financial relationships with ineligible companies.

Purpose/Background: Colon cancer is a serious health problem, where misdiagnosis could be fatal. A universally agreed minimal number of lymph nodes needed to be resected for appropriate TNM staging continues to be debated. Our goal is to derive a target lymph node threshold (TLNT) of the minimum number of lymph nodes that need to be resected by applying the log odds of positive (metastatic) lymph nodes (LODDS) to negative lymph nodes to analyze the distribution of positive to negative lymph nodes.

Methods/Interventions: A retrospective study was performed, using the National Cancer Database (NCDB) to examine left-sided and right-sided colon cancer cases (2015-2020). LODDS distributions were evaluated for patients with N1 and N2 disease. LODDS distributions were separated by right-sided, left-sided, and sigmoid colon cancer, and a target lymph node resection threshold (TLNT) to encompass 90% of node-positive cases was determined by examining the LODDS distributions across N1 and N2 cases.

Results/Outcomes: The minimum threshold number of lymph nodes to be resected to appropriately diagnose 90% of nodal positive patients is 23 for left-sided colon cancer, 24 for right-sided colon cancer, and 22 for sigmoid colon cancer. To cover 90% of N2 stage patients, a minimum of 7 lymph nodes is needed in both right, left, and sigmoid colons.

Conclusion/Discussion: When applying the log of the odds of positive (LODDS) to negative lymph nodes to determine the minimum threshold for lymph node resection, our calculated minimums needed to encompass 90% of nodal positive patients are higher than the 12-lymph node minimum recommended by current guidelines.