Lymph node involvement in colon cancer patients decreases with age; a population based analysis

Abstract Background The variation in nodal involvement between age groups has not been thoroughly studied in colon cancer, but it may affect strategies for extent of resection in elderly patients. The objective of our study was to compare nodal involvement in colon cancer patients, with a focus on surgical staging practices in the elderly. Methods We extracted data from the Surveillance, Epidemiology and End Results registry on 208,077 patients diagnosed with stage I-III colon adenocarcinoma between 2000 and 2010. Patients undergoing colon resection, patients with adequate staging with ≥12 lymph nodes examined (LNE, n = 114,351) and with node-positive cancers were compared in age groups using chi-squared test. Relative risk (RR) of node-positive cancer was compared in a multivariable log-linear model, and relative survival in a flexible parametric model. Results While the rates of colon resection were similar in all age groups, older patients were significantly less likely to have ≥12 LNE ( P