Quality of Pathology Reporting Impacts on Lymph Node Yield in Colon Cancer

2007 ◽  
Vol 25 (4) ◽  
pp. 463-463 ◽  
Author(s):  
Nicholas A. Rieger ◽  
Frances S. Barnett ◽  
James W.E. Moore ◽  
Sumitra S. Ananda ◽  
Matthew Croxford ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Node Yield ◽  
Pathology Reporting ◽  
Node Yield

Association of suboptimal lymph node yield with inferior survival in resected stage 1 colon cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3601-3601
Author(s):  
Alexander C Chacon ◽  
Alexa D. Melucci ◽  
Nicholas A. Ullman ◽  
Paul Burchard ◽  
Anthony S. Casabianca ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Stage I ◽  
Lymph Node Yield ◽  
Multivariable Analyses ◽  
Stage 1 ◽  
Node Yield

3601 Background: A minimum of 12 lymph nodes are required during colectomy to accurately stage colon cancer. Prior studies in stage II colon cancer patients demonstrate association of inadequate lymph node examination (LNE) with worse overall survival (OS). No large-scale analogous studies related to LNE have been completed in stage I colon cancer patients. We evaluated patients with stage I colon cancer to determine the association between lymph node yield and OS. Methods: We reviewed the National Cancer Database between 2004-2015 to identify patients with pathologic stage I colon cancer (pT1N0 or pT2N0) who underwent definitive surgical resection. Patients who received radiation therapy or had missing values were excluded. Clinical and demographic characteristics were analyzed. Based on LNE, patients were stratified into 4 cohorts (LNE, 0-5, 6-11, 12-19, 20+) and 2 cohorts (0-11, 12+). Univariable and multivariable analyses were performed to identify variables associated with OS. Kaplan-Meier survival curves were computed to compare the cohorts. Results: We included 81,909 patients for analyses. Median age at diagnosis was 69. A majority were female (51.1%), white (83.8%), received care in a community cancer program (59.5%), and had a Charlson-Deyo score of 0 (66.6%). Only 0.7% of patients had a margin positive resection with a 2.5cm median tumor size. Patients were similarly split between pT1 and pT2. Suboptimal LNE was noted in 27.8% of patients. Patients with LNE were distributed - 10.7% (0-5), 17.1% (6-11), 43.4% (12-19) and 28.9% (20+). Postoperative 30-day mortality was 1.9%. 521 (0.7%) received systemic therapy. Ten-year survival in patients with 0-5 LNE was 52.8% compared to 60.1% with 20+ LNE. On multivariable analyses, patients aged ≥ 69, male sex, increasing tumor size (quartile), pT2 staging and a higher Charlson-Deyo score independently predicted worse OS (p < 0.001). LNE categories were significantly associated with OS (p < 0.001) (Table). On regrouping into 0-11 and 12+ LNE groups, 0-11 LNE group predicted worse OS (HR 1.22, p < 0.001). On multivariable analysis, the above variables continued to show similar association with OS (p < 0.001). Conclusions: Our study demonstrates that lymph node yield is associated with overall survival in patients with stage 1 colon cancer undergoing surgical resection. Furthermore, patients with suboptimal lymph node yield are associated with an inferior overall survival compared to those with optimal lymph node yield. Moreover, this study finds that a large number of patients ( > 25%) continue to have suboptimal lymph node yields. Future efforts should focus on improving the lymph node yield with optimal efforts by the surgeon and pathologist. Future studies should examine the role of systemic therapy in patients with inadequate lymph node yield.[Table: see text]

scholarly journals High Lymph Node Yield is Related to Microsatellite Instability in Colon Cancer

2011 ◽  
Vol 19 (4) ◽  
pp. 1222-1230 ◽  
Author(s):  
E. J. Th. Belt ◽  
E. A. te Velde ◽  
O. Krijgsman ◽  
R. P. M. Brosens ◽  
M. Tijssen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Microsatellite Instability ◽  
Lymph Node Yield ◽  
High Lymph Node ◽  
Node Yield

Does Specialized Surgical Training Increase Lymph Node Yield in Colon Cancer?

2009 ◽  
Vol 75 (10) ◽  
pp. 887-891
Author(s):  
Michael B. Nicholl ◽  
Byron E. Wright ◽  
W. Charles Conway ◽  
Trista Aarnes-Leong ◽  
Myung-Shin Sim ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Surgical Training ◽  
Surgical Oncology ◽  
Stage Ii ◽  
Lymph Node Yield ◽  
Recent Trends ◽  
Nodal Yield ◽  
Node Yield ◽  
Registry Database

Most colon cancer resections do not meet the 12-lymph node minimum recommended in 2001 National Cancer Institute (NCI) panel guidelines. Previous reports suggest surgical training influences lymph node recovery. We hypothesized that recent trends show improved results for lymphadenectomy regardless of specialty. The cancer registry database at a large community hospital with an academic surgical oncology training program was queried to identify resections performed for colon cancer before (1995 to 2000) and after (2001 to 2006) NCI guideline publication. There were no changes in pathology procedures between 374 early and 411 later procedures. The later period brought increases in mean total lymph nodes (15.4 vs 10.4, P < 0.0001), total positive nodes (1.8 vs 1.2, P = 0.005), and the percentage of procedures yielding 12 or more nodes (overall: 65.9 vs 36.0%, P < 0.0001; Stage II and III disease: 73.0 vs 41.4%, P < 0.003). In addition, mean nodal yield increased (P < 0.0001) for fellowship-trained surgeons (16.7 vs 11.2) and nonfellowship-trained surgeons (14.9 vs 10.2). Single-registry data show that since 2001, most colon resections exceed minimum recommendations for lymph node recovery regardless of surgical training. The increased rate of adequate lymphadenectomy for Stage II and III disease is encouraging because this patient population will benefit most by accurate staging of colon cancer.

No change in lymph node positivity rate despite increased lymph node yield and improved survival in colon cancer

2014 ◽  
Vol 50 (18) ◽  
pp. 3221-3229 ◽  
Author(s):  
F.N. van Erning ◽  
R.M.P.H. Crolla ◽  
H.J.T. Rutten ◽  
L.V. Beerepoot ◽  
J.H.J.M. van Krieken ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Node Yield ◽  
Node Yield

scholarly journals How does lymph node yield affect survival outcomes of stage I and II colon cancer?

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Chi Chung Foo ◽  
Clement Ku ◽  
Rockson Wei ◽  
Jeremy Yip ◽  
Julian Tsang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Stage I ◽  
Survival Outcomes ◽  
Lymph Node Yield ◽  
Node Yield

Do Better Operative Reports Equal Better Surgery? A Comparative Evaluation of Compliance With Operative Standards for Cancer Surgery

2020 ◽  
Vol 86 (10) ◽  
pp. 1281-1288
Author(s):  
Matthew E. Reeves ◽  
Ross Mudgway ◽  
Sarah K. Lee ◽  
Nikita Kadakia ◽  
Chelsea Santos ◽  
...  
Keyword(s):  
Lymph Node ◽  
Surgical Outcomes ◽  
Comparative Evaluation ◽  
Cancer Surgery ◽  
Lymph Node Yield ◽  
Significant Difference ◽  
American College Of Surgeons ◽  
Node Yield

To improve the quality of cancer operations, the American College of Surgeons published Operative Standards for Cancer Surgery, which has been incorporated into Commission on Cancer (CoC) accreditation requirements. We sought to determine if compliance with operative standards was associated with technical surgical outcomes. Oncologic operative reports from 2017 at a CoC and non-CoC institution were examined for documentation of Operative Standards essential steps. Lymph node (LN) yield for lung and colon cases and re-excision rates for breast cases were recorded. Correct documentation was poor for colon, breast, and lung cases with numerous elements documented in <10% of operative reports at both centers. For lung cases, there was no significant difference in meeting ≥10 LN benchmark or average LN yield between the 2 institutions. For colon cases, average lymph node yield was lower in the non-CoC facility, but there was no significant difference in meeting ≥12 LN benchmark. For breast cases, re-excision rates were similar in both programs. Many essential steps in Operative Standards were poorly documented in operative reports, regardless of CoC status. Achieving benchmark technical surgical outcomes was not associated with documented compliance with these standards. Whether improved documentation leads to better surgical outcomes requires further investigation.

Time-Dependent Trends in Lymph Node Yield and Impact on Adjuvant Therapy Decisions in Colon Cancer Surgery: An International Multi-Institutional Study

2012 ◽  
Vol 19 (13) ◽  
pp. 4178-4185 ◽  
Author(s):  
Alexander Stojadinovic ◽  
Aviram Nissan ◽  
Zev Wainberg ◽  
Perry Shen ◽  
Martin McCarter ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Cancer Surgery ◽  
Time Dependent ◽  
Lymph Node Yield ◽  
Colon Cancer Surgery ◽  
Node Yield
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