Assessment of the Necessity of Gastrocolic Ligament Lymph Node Dissection and Related Risk Factors in Right Hemicolectomy for Colon Cancer: A Prospective Observational Study

Purpose: This prospective observational study aims to evaluate the necessity of gastrocolic ligament lymph node (GCLN) dissection in the treatment of right-sided colon cancer, with a focus on the prevalence of lymph node metastasis and associated risk factors. Methods: Between October 2019 and December 2021, 154 patients diagnosed with right-sided colon cancer underwent complete mesocolic excision (CME), central vascular ligation (CVL), and gastrocolic ligament lymph node (GCLN) dissection. Lymph node stations were defined in accordance with the criteria of the Japanese Society for Cancer of the Colon and Rectum, and the incidence of lymph node metastasis at each station was documented. Results: The median number of GCLN was one, with a 0.65% metastasis rate observed in one patient. Multivariate analysis revealed poorly differentiated pathological grade (P = 0.038) as a significant risk factor for skipped metastasis. Additionally, female gender (p = 0.012) and perineural invasion (p = 0.004) were significant for tumor deposits. Conclusion: ​ Based on the findings of this study, routine gastrocolic ligament lymph node (GCLN) dissection is not routinely indicated in all patients undergoing surgery for right-sided colon cancer. Trial registration: Clinical Trial Registry: Chinese Clinical Trial Registry (ChiCTR), http://www.chictr.org.cn/ Trial Registration Number: ChiCTR2100042014 Clinical Trial Registration Date: 2019-1-1