Romanian medical JouRnal – Volume 69, no. 2, 2022 57 ORIGINAL ARTICLE Ref: Ro Med J. 2022;69(2) DOI: 10.37897/RMJ.2022.2.3 Prognostic impact of Lymph node resection in stage II colon cancer: a prospective study from a tertiary hospital center Diana Chetroiu 1,2 , Mircea Beuran 1,3 , Petruta Violeta Filip 1,2 , Sorina Diaconu 1,2 , Carmen Orban 1 , Corina Silvia Pop 1,2 , Alexandru Laurentiu Chiotoroiu 1,3 1 Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 2 Department of Internal Medicine and Gastroenterology; University Emergency Hospital of Bucharest, Bucharest, Romania 3 Department of Surgery; Emergency Clinical Hospital of Bucharest, Romania Corresponding author: Petruta Violeta Filip, MD, PhD E-mail: petruta.filip@umfcd.ro ABSTRACT Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of resected lymph nodes, and according to the latest guidelines, it is recommended that at least 12 lymph nodes should be resected for optimal staging. The aim of this study is to evaluate the role of lymph node resection, in stage II colon cancer and the implication of sub- optimal lymph node resection on disease free survival and overall survival. Patients and methods. This was a prospective study that included 130 patients with stage II colon cancer who were mon- itored between October 2014 and October 2016. The relation between patients’ tumour characteristics that include number of lymph node resection and the use of adjuvant chemotherapy using Chi test and multiple logistic regression was analyzed. The disease-free survival and overall survival were estimated with the Kaplan-Meier method and compared with the log-rank test. Results. 130 patients with stage II colon cancer were recruited. 56 patients were treated with surgery alone and 74 pa- tients received flourouracil- based chemotherapy after surgery. Patients' age varied from 37 years to 81 years. According to the number of resected lymph nodes, patients were divided into two groups - with less than 12 lymph nodes resected and at least 12 lymph nodes resected. The number of resected lymph nodes varied from 2 to 32 lymph nodes. Median follow up was 36 months. Suboptimal resections of lymph nodes confirmed to be a negative prognostic factor for surviv- al without disease recurrence. Conclusion. Data results confirmed the importance of lymph node resection as a prognostic factor for stage II colon can- cer and the role of chemotherapy for patients with suboptimal lymph node resection. Keywords: colon cancer, lymph nodes, resection, treatment Article History: Received: 25 May 2022 Accepted: 25 Iunie 2022 INTRODUCTION Colon cancer is an important health problem around the globe, with an increasing incidence in the past several years [1-4]. Surgery remains the main treatment with curative intent for stage I-III colon cancers [1-4]. The recommended procedure is colectomy with en bloc removal of regional lymph nodes [4-7]. Studies correlated patients’ survival with the number of resected lymph nodes, demon- strating a positive association [4-7]. International Union Agains Cancer, the 8th edi- tion of the American Joint Committee on Cancer staging manual, College of American Pathologists and European Society of Medical Oncology have all recommended resection and evaluation of at least 12 lymph nodes in order ensure adequate N staging,