The distribution of lymph node metastases in right-sided colon cancer

We reviewed the surgical results of 57 patients with rightsided colon carcinoma (RCC) with special reference to lymph node metastasis. In 45 cured patients, 25 showed no lymph node metastasis (n0), 19 showed a low or moderate degree of lymph node metastasis (n1, n2), and only one showed a high degree of lymph node metastasis (n3). As for the remaining 12 cases, the reasons that operation did not lead to a cure were liver or lung metastasis (66%), peritoneal spread (17%), or extensive lymph node metastasis (17%). Among these patients, only one may have died from insufficient lymph node dissection (R2<n3). The presence of lymph node metastasis was predicted by the serum carcinoembryonic antigen level (>3.0 ng/ml) and histologic type (other than well differentiated). These results indicate that complete removal of the group 1 and 2 nodes (R2 dissection) is a feasible operation for RCC.