Increased lymph node harvest from colorectal cancer resections using GEWF solution: a randomised study

2008 ◽  
Vol 61 (11) ◽  
pp. 1203-1208 ◽  
Author(s):  
L H Iversen ◽  
S Laurberg ◽  
R Hagemann-Madsen ◽  
H Dybdahl
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
University Hospital ◽  
Node Negative ◽  
Lymph Node Harvest ◽  
Randomised Study ◽  
Standard Manner ◽  
N Stage ◽  
Tumour Origin

Background:The lymph node harvest from colorectal specimens is pivotal for patients with colorectal cancer (CRC), independent of N stage.Aims:To determine whether the use of GEWF solution (glacial acetic acid, ethanol, distilled water and formaldehyde) could improve the lymph node harvest in CRC specimens.Methods:Consecutive fresh colonic (n = 60) and rectal (n = 60) specimens from patients with primary CRC resected at Aarhus University Hospital THG between March 2006 and July 2007 were randomised to either conventional preparation or GEWF preparation and examined in a standard manner.Results:For colonic as well as rectal specimens, the GEWF solution increased the mean lymph node harvest from 9 and 10 to 16 and 17 lymph nodes per specimen compared to conventional prepared specimens (p<0.001). Using the recommended threshold of 12 lymph nodes to ensure adequacy of nodal harvest, the adequacy increased from less than half to almost three quarters independent of tumour origin (p<0.037). The proportion of node-negative specimens was not significantly different between the two preparation groups.Conclusion:The use of GEWF solution in patients with CRC significantly increases the lymph node harvest of resected specimens.

Impact of robotic-assisted approach on lymphadenectomy for colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 787-787
Author(s):  
Reza Gamagami ◽  
Paul Kozak ◽  
Venkata R. Kakarla
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Lymph Nodes ◽  
Demographic Data ◽  
Robotic Assisted ◽  
Lymph Node Harvest ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

787 Background: In most recent years, robotic assisted laparoscopic surgery (RALS) has proven to be a viable alternative to laparoscopic and traditional open surgery for colorectal cancer. Obtaining the adequate number of lymph nodes is not only essential for accurate staging, but also impacts both prognosis and the need for adjuvant chemotherapy. To date, the efficacy of lymph node harvest for RALS is not well studied or established. The aim of our study is to analyze the impact of RALS on lymphadenectomy for colorectal cancer. Methods: We performed a retrospective review of patients who underwent curative resections for colorectal cancer over a five-year period at a single institution by a single surgeon. Resections were classified as right-sided, sigmoid, or rectal, and subdivided into robotic and non-robotic surgery groups. The demographic data and histopathology were obtained, with an emphasis on the number lymph nodes harvested (LNH) during resections. Emergencies and non-curative resections were excluded. Results: Between January 2010 and December 2015, 136 patients with colorectal cancer underwent curative resections. Sixty-four underwent right-sided resections (28 laparoscopic, 36 robotic). Twenty-five underwent sigmoid resections (11 laparoscopic, 14 robotic), and 47 underwent rectal resections (15 open, 32 robotic). There was no significant difference in age, sex, BMI and ASA scores between the cohorts examined. The mean number of LNH with RALS was significantly higher in all three groups (right-sided—24 vs. 15 ( p= .0001), sigmoid—16 vs. 12 ( p= .046), rectal—19 vs. 4 ( p= .0016)). There was no difference in the rate of adequate lymph node extraction for staging purpose, i.e., 12 lymph nodes in all three groups. Conclusions: Robotic-assisted laparoscopic surgery is associated with a statistically significant increase in lymph node harvest for right-sided, sigmoid and rectal resections for malignancy. Future studies with larger sample sizes are necessary to validate these findings.

scholarly journals Lymph node ratio and liver metachronous metastases in colorectal cancer

2016 ◽  
Author(s):  
Giovanni Li Destri ◽  
Giuseppe Privitera ◽  
Gaetano La Greca ◽  
Roberto Scilletta ◽  
Antonio Pesce ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Lymph Node Ratio ◽  
Statistical Significance ◽  
Node Negative ◽  
Lymph Node Sampling ◽  
Node Ratio ◽  
Selection Of

Abstract Objective The authors seek to assess whether the LNR could predict the risk of metachronous liver metastases. Background data Using the goal of sampling 12 lymph nodes for a proper staging of colorectal cancer is often "uncommon" and the lymph node ratio (LNR) is what allows for a better prognosis selection of patients. Methods A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR. Results The number of lymph nodes sampled in group "stage I" was significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (p &lt;0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P =0.01). Conclusions The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with node-negative cancer (I+II) who developed liver metastases, leads us to believe that some patients have been understaged. We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better sub-stratify "node-positive" patients.

The impact of lymph node dissection in patients with colorectal cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17055-17055
Author(s):  
R. W. Gentry ◽  
R. Govindarajan ◽  
H. J. Spencer ◽  
G. Dykstra-Long
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Node Negative ◽  
Time Of Surgery ◽  
Node Positive ◽  
Node Positive Disease ◽  
The Impact

17055 Background: The role of extended lymphadenectomy on survival of patients with colorectal cancer is unclear. Survival in these patients is inversely proportional to the stage of disease. The prognostic significance of inadequate lymph node dissection is not understood. To understand the impact of the number of lymph nodes removed at the time of surgery on survival, we conducted a retrospective study of patients with colorectal cancer treated at the Central Arkansas Veterans Healthcare System, Little Rock, AR. Methods: Data on 531 patients with a diagnosis of colorectal cancer from January 1991 to October 2005 was obtained from the tumor registry. The number of lymph nodes dissected the number of positive and negative lymph nodes for each patient, treatment received and overall survival was analyzed. The number of resected nodes was grouped as follows: none (LNG0), 1–5 (LNG1), 6–10 (LNG2), and > 10 (LNG3). Log rank test was used to evaluate difference in survival between the groups. Results: There were 451 Caucasians, 80 African Americans, 523 males and 8 females in the study. The median age was 69 yrs (range: 29–100). Rectal cancer patients had fewer nodes dissected compared to colon cancer (p <0.001). There was no survival difference between LNG0, LNG1, LNG2 and LNG3 (p=0.435). The number of lymph nodes removed did not have an impact on survival among those who had node negative disease (0.435) and node positive (0.458) disease. LNG0 patients had the same prognosis as those with node negative disease (P=0.435) who had better survival compared to node positive disease. (p=0.029). However, LNG0 patients had similar survival compared to LNG1 subset of patients and those in LNG3 had a trend towards better survival, though not statistically significant. LNG0 subjects received less chemotherapy (p=0.018) and radiation therapy (p=0.01) compared to those who had lymphadenectomy. Conclusions: The number of nodes removed at the time of surgery did not affect survival in subjects with node negative and node positive disease. Patients who did not have any identifiable nodes at the time of surgery had the same prognosis as those who had node negative disease. Patients with more than 10 negative nodes dissected had a trend towards better survival although not statistically significant. No significant financial relationships to disclose.

scholarly journals Cervical lymph node enlargement as the initial manifestation of rectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tong-Hui Xie ◽  
Peng Su ◽  
Jian-Guo Hong ◽  
Hui Zhang
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Clinical Manifestations ◽  
Initial Symptom ◽  
Cervical Lymph Nodes ◽  
Supraclavicular Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

scholarly journals Predicting gastric cancer outcome from resected lymph node histopathology images using deep learning

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Xiaodong Wang ◽  
Ying Chen ◽  
Yunshu Gao ◽  
Huiqing Zhang ◽  
Zehui Guan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Deep Learning ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Main Method ◽  
Learning Framework ◽  
Prognostic Assessment ◽  
N Stage ◽  
Cancer Outcome ◽  
Whole Slide Images

AbstractN-staging is a determining factor for prognostic assessment and decision-making for stage-based cancer therapeutic strategies. Visual inspection of whole-slides of intact lymph nodes is currently the main method used by pathologists to calculate the number of metastatic lymph nodes (MLNs). Moreover, even at the same N stage, the outcome of patients varies dramatically. Here, we propose a deep-learning framework for analyzing lymph node whole-slide images (WSIs) to identify lymph nodes and tumor regions, and then to uncover tumor-area-to-MLN-area ratio (T/MLN). After training, our model’s tumor detection performance was comparable to that of experienced pathologists and achieved similar performance on two independent gastric cancer validation cohorts. Further, we demonstrate that T/MLN is an interpretable independent prognostic factor. These findings indicate that deep-learning models could assist not only pathologists in detecting lymph nodes with metastases but also oncologists in exploring new prognostic factors, especially those that are difficult to calculate manually.

scholarly journals The Prognostic Value of Lymph Nodes Dissection Number on Survival of Patients with Lymph Node-Negative Gastric Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Wu Song ◽  
Yujie Yuan ◽  
Liang Wang ◽  
Weiling He ◽  
Xinhua Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Tumor Invasion ◽  
Prognostic Value ◽  
Operation Time ◽  
Invasion Depth ◽  
Node Negative ◽  
Tumor Invasion Depth

Objective.The study was designed to explore the prognostic value of examined lymph node (LN) number on survival of gastric cancer patients without LN metastasis.Methods.Between August 1995 and January 2011, 300 patients who underwent gastrectomy with D2 lymphadenectomy for LN-negative gastric cancer were reviewed. Patients were assigned to various groups according to LN dissection number or tumor invasion depth. Some clinical outcomes, such as overall survival, operation time, length of stay, and postoperative complications, were compared among all groups.Results.The overall survival time of LN-negative GC patients was50.2±30.5months. Multivariate analysis indicated that LN dissection number(P<0.001)and tumor invasion depth(P<0.001)were independent prognostic factors of survival. The number of examined LNs was positively correlated with survival time(P<0.05)in patients with same tumor invasion depth but not correlated with T1 stage or examined LNs>30. Besides, it was not correlated with operation time, transfusion volume, length of postoperative stay, or postoperative complication incidence(P>0.05).Conclusions.The number of examined lymph nodes is an independent prognostic factor of survival for patients with lymph node-negative gastric cancer. Sufficient dissection of lymph nodes is recommended during surgery for such population.

Sign in / Sign up

Export Citation Format

Share Document