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Nodal invasion is one of the most importantprognostic factors in rectal cancer. The number of harvested lymph nodes appears to relate withprognosis.Retrospective analysis of 194 rectal cancer patients consecutively treated at a University Hospital with curative intent and NO or N1 between January 2002 and December 2007 was performed Comparison was made of clinical and pathological findings and overall survival of NO patients with more than 12 resected lymph nodes (Group A-n = 65), NO patients with < 12 LN (Group B-n = 61) and N1 patients (Group C-n = 68).Two-thirds of patients (n = 126) were classified as NO, but 48% of these had a harvest of < 12 LN. Although the pathological findings were similar between Groups A and B (differentiation, lymphatic and venous invasion), the surgical findings (specimen length, tumour size and distance to margin) and the overall survival of Group-B (NO < 12LN) were similar to that of Group C (N1). The 5-year survival was 89%, 73% and 78%, respectively for groups A, B and C (P = 0.2).Group B patients (NO < 12LN) had clinical and pathological findings intermediately between GroupA (NO > 12LN) and Group-C (N1). The overall survival of patients with < 12LN on the surgical specimen is similar to that of N1 patients.