factors. Few studies compare CME to high-quality D2 resection, and the concepts of CME and CVL are often used interchangeably. There is a paucity of studies which directly compare high-quality conventional colectomy (D2 lymphadenec­tomy) with either D3 lymphadenectomy or CVL with lymphadenectomy along the root vessels. Many of the studies use historical controls when less attention was paid to lymph node retrieval and pathological assessment. Only one study reported sig­nicantly higher survival for stage 3 patients in the CME group compared to con­ventional resection group [13] (Table 11.2). The other four studies did not demonstrate a difference in overall survival between conventional and CME resec­tions. Disease-specic survival was higher in two of the four studies [13, 34] which reported this endpoint. Despite the CME groups and D3 lymphadenectomy cohorts all having a signicantly longer distance from tumor to high tie and lymph node yields, this apparent improvement in pathological surrogates has not been associ­ated with a consistent improvement in survival (Table11.2). This raises the question of what is the incremental benet of an “extended” lymphadenectomy with respect to oncologic outcomes. The following section highlights some studies where CME or D3 resections are compared to a more standardized approach involving D2 lymphadenectomy.