Evaluation of mesenteric lymph nodes affection in right colonic cancer treated with D3 right hemicolectomy

Objective: To evaluate the prevalence, distribution, and pathological characteristics of mesenteric lymph node involvement in patients undergoing D3 right hemicolectomy for right colon cancer (RCC). Methods: Hundred consecutive patients diagnosed with right colon adenocarcinoma who underwent D3 right hemicolectomy with complete mesocolic excision (CME) and central vascular ligation (CVL) between July 2022 and July 2024 were included. All resected specimens, including the complete mesocolon, were meticulously examined for lymph nodes and then pathologically assessed for metastatic involvement. Tumor stage, grade, presence of vascular or perineural invasion, and number of harvested and positive lymph nodes, were collected and analyzed. Results: Preliminary results indicated that a significant proportion of patients presented with positive mesenteric lymph nodes (MLNs). The mean number of harvested lymph nodes was 25.3 ± 4.1, with 40% of patients demonstrating nodal metastasis. Nodal involvement was predominantly observed in the pericolic and intermediate groups, with a small percentage of positive nodes in the D3 apical region [5%]. There was a statistically significant association between nodal status and tumor T stage (p<0.001), tumor differentiation (p=0.02), and the presence of vascular invasion (p=0.01). Conclusion: D3 right hemicolectomy effectively allows for the comprehensive evaluation of mesenteric lymph node involvement in right colon cancer.