Oncologic standards in colon cancer resection: from margins to lymph node yield and mesentery

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Adequate longitudinal margins of 5–7 cm are recommended for most colon tumors, extending to 10 cm for advanced T stage or specific arterial geometry.
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Lymph node assessment beyond the historical minimum of 12 nodes improves staging accuracy and survival, with optimal yields around 18–22 examined nodes.
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Complete mesocolic excision with central vascular ligation increases nodal yield and specimen quality without excess morbidity in optimized settings.
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An oncologically adequate colectomy should aim for R0 resection, mesenteric resection to the feeding-vessel origin, and systematic reporting of tumor deposits.
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Structured training and routine audits are essential for the effective implementation of CME/CVL/D3, particularly for stage III right colon cancers.

Frontiers In Surgery

by Mariarosaria Portinaio, Carlo Alberto Schena, Michele Ammendola, Geoffrey Yuet Mun Wong, Patricia Tejedor, Fausto Rosa, Elisa Reitano, Corrado Pedrazzani, Jim Khan, Nicola de’Angelis
June 22, 2026

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