Guidelines recommend regional lymphadenectomy with a lymph node yield (LNY) of at least 12 lymph nodes (LN) for adequate colon cancer (CC) staging. LNY ≥22LN may improve survival, especially in right-sided CC [Lee et al., Surg Oncol, 27(3), 2018]. This multicentric retrospective cohort study evaluated the impact of LNY and tumor laterality on CC staging and survival. Patients with stage I-III CC that underwent surgery from 2012 to 2018 were grouped according to LNY: <22 and ≥ 22. Primary outcomes were LN positivity (N+ rate) and disease-free survival (DFS). Overall survival (OS) was the secondary outcome. Exploratory analyses were performed for laterality and stage. We included 795 patients (417 < 22LN, 378 ≥ 22LN); 53% had left-sided CC and 29%/37%/38% had stage I/II/III tumors. There was no association between LNY ≥22LN and N+ rate after adjustment for grade, T stage, lymphovascular invasion (LVI) and perineural invasion; a trend for a higher N+ rate in left-sided CC was identified (interaction p = 0.033). With a median follow-up of 63.6 months for DFS and 73.2 months for OS, 254 patients (31.9%) relapsed and 207 (26.0%) died. In multivariate analysis adjusted for age, ASA score, laparoscopic approach, T/N stage, mucinous histology, LVI and adjuvant chemotherapy, LNY ≥22LN was significantly associated with both DFS (HR 0.75, p = 0.031) and OS (HR 0.71, p = 0.025). Restricted cubic spline analysis showed a more significant benefit for right-sided CC. LNY ≥22LN was associated with longer DFS and OS in patients with operable CC, especially for right-sided CC.

Purpose: Colorectal cancer (CRC) significantly impacts the quality of life (QoL) of survivors, yet detailed assessments of long-term QoL are sparse. This study evaluates QoL among CRC survivors, examining the influence of different treatments and patient characteristics on outcomes. Methods: We conducted a cross-sectional study at a tertiary cancer center in Portugal, enrolling CRC patients who underwent curative surgery from 2013 to 2022. QoL was assessed using the EORTC QLQ-C30 and QLQ-CR29 at 1-, 3-, 5-, and 10-year follow-up intervals. Subgroup analyses were performed based on tumor location, radiotherapy administration, chemotherapy administration, presence of a stoma, and time since treatment, with sociodemographic and clinical factors examined on univariate and multivariate analysis. Results: Of the 825 eligible patients, 324 were invited and 179 participated (response rate: 55.2%). Overall, patients reported high global QoL and functional scores with low symptom scores, comparable to those of the general population. However, rectal cancer survivors experienced poorer outcomes in role and social functioning, body image, and symptom management. Those receiving radiotherapy or chemotherapy reported more symptoms, with chemotherapy recipients showing lower functional scores. Patients with a stoma had significantly lower QoL across functional and symptom scales. Long-term survivors reported decreased physical functioning. Multivariate analysis identified female gender, open surgery, and chemotherapy as factors associated with reduced QoL. Conclusion: This study highlights significant disparities in QoL outcomes between CRC survivors, with QoL influenced by gender, cancer location, radiotherapy or chemotherapy, stoma presence, and survivorship duration, underscoring the need for personalized support programs and tailored care plans.

Background: Surgical site infections (SSIs) are among the most common postoperative complications in colorectal surgery, and associate with increased morbidity, prolonged recovery, and higher healthcare costs. Most studies combine all SSI categories, potentially overestimating economic burden due to higher severity of organ/space infections. The specific cost impact of incisional SSIs—superficial and deep infections—remains underexplored, despite its prevention potential. This study aimed to evaluate hospital costs associated with incisional SSIs following colorectal resection. Methods: A retrospective cohort study was conducted at a tertiary oncologic center, including patients who underwent surgical resection for primary neoplasms of the colon, rectum, or anal canal between 2018 and 2023. Patients with incisional SSIs were matched 1:1 to controls without SSI using propensity scores based on demographic and surgical variables. Total hospital costs within 60 days postoperatively were analyzed using real-world, institution-specific cost data. Multivariate regression was used to identify independent cost predictors. Results: Among 985 eligible patients, 176 (17.9%) developed an incisional SSI. After matching, 346 patients (173 pairs) were included in the cost analysis. Mean hospital costs were significantly higher in the SSI group (€6,065.93 vs €5,089.97; P < 0.001), primarily due to prolonged hospitalization and increased outpatient care use (medical and nursing consultations). Incisional SSI was an independent predictor of higher costs, along with open surgery, comorbidities and stoma presence. Conclusions: Incisional SSIs associated with higher hospital costs after colorectal surgery. These findings support the implementation of targeted SSI prevention strategies to reduce complications and optimize healthcare resource use.