Correlation analysis of the extent of lymph node dissection in laparoscopic radical resection of colon cancer and long-term prognosis

Background The extent of lymph node dissection (D1, D2, D3) during laparoscopic radical resection for colon cancer has significant implications on survival, recurrence, and postoperative outcomes. This study aims to compare the effectiveness and safety of these dissection strategies. Methods A retrospective, multicenter cohort study was conducted, analyzing medical records of 100 patients diagnosed with stage I, II, or III colon cancer. Patients were grouped based on the lymphadenectomy strategy: D1 (reduced), D2 (standard), or D3 (extended). The primary endpoints included overall survival (OS), recurrence rates and disease-free survival (DFS). Secondary endpoints included postoperative complications, and quality of life (QoL). Results The 5-year survival rate was highest in the D3 group (82%), followed by D2 (75%), and D1 (65%) ( P = 0.02). D3 dissection resulted in the lowest recurrence rate at 8%, compared to 12% for D2 and 18% for D1 ( P = 0.05). However, D3 was associated with significantly higher complications, including a 35% complication rate, compared to 25% for D2 and 15% for D1 ( P = 0.03). Postoperative quality of life scores were lowest in the D3 group, particularly for mobility and self-care ( P = 0.03). Conclusion D3 lymphadenectomy provided the best oncological outcomes but increased surgical morbidity, making it suitable for high-risk patients. D2 offered a balanced approach with moderate survival benefits and fewer complications, while D1 may have sufficed for low-risk cases. The choice of dissection strategy should have been individualized based on patient risk factors and tumor characteristics.