Trial reportWorld journal of surgery2011
Improved lymph node harvest from resected colon cancer specimens did not cause upstaging from TNM stage II to III.
Trial report in World journal of surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- A Modified Tumor-Node-Metastasis Classification for Primary Operable Colorectal Cancer.JNCI cancer spectrum · 2021Trial
- The Value of Sentinel Lymph Node Mapping for the Staging of Node-Negative Colon Cancer: Propensity Score and Mediation Analyses.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- How does lymph node yield affect survival outcomes of stage I and II colon cancer?World journal of surgical oncology · 2020Article
- Harvest of lymph nodes in colorectal cancer depends on demographic and clinical characteristics of the patients.International journal of colorectal disease · 2018Article
- Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre.World journal of gastrointestinal surgery · 2017Article
- Stage migration vs immunology: The lymph node count story in colon cancer.World journal of gastroenterology · 2015Review
- Short- and long-term outcomes for patients with splenic flexure tumours treated by left versus extended right colectomy are comparable: a retrospective analysis.Surgery today · 2014Article
- Short term results of complete (D3) vs. standard (D2) mesenteric excision in colon cancer shows improved outcome of complete mesenteric excision in patients with TNM stages I-II.Techniques in coloproctology · 2014Article
- Colorectal cancer and lymph nodes: the obsession with the number 12.World journal of gastroenterology · 2014Review
- Increased lymph node yield in colorectal cancer is not necessarily associated with a greater number of lymph node positive cancers.PloS one · 2014Article
- Extended lymphadenectomy in colon cancer is debatable.World journal of surgery · 2013Article
- The impact of the lymph node ratio is greater than traditional lymph node status in stage III colorectal cancer patients.World journal of surgery · 2013Article
- A nodal positivity constant: new perspectives in lymph node evaluation and colorectal cancer.World journal of surgery · 2013Review
- More is not always better.World journal of surgery · 2011Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of lymph nodes retrieved and examined from a resected colon cancer specimen may be crucial for correct staging. We examined if efforts to increase the lymph node harvest to more than 12 lymph nodes per specimen would upstage some patients from TNM stage II to III.
methodsThree hospitals compared results from 2000 with those of 2007 in 421 resected patients with stage II and III colon cancer. Hospital A endeavored to improve the surgical procedure while the pathologists enhanced the quality of lymph node sampling. Hospital B did not make any marked changes, while hospital C introduced the GEWF lymph node solvent (glacial acetic acid, ethanol, distilled water, and formaldehyde) in their pathology method.
resultsIn 2000, 12 or more lymph nodes were harvested in 39.6, 45.0, and 21.1% of the specimens from the three hospitals, while the figures for 2007 were 85.7, 42.0, and 90.3%, respectively. The significant increase in lymph node harvest in two of the hospitals in 2007 compared to 2000 (p < 0.001) did not affect the share of patients with stage III in 2007 (38.7%) compared to 2000 (44.1%) (p = 0.260). The number of positive lymph nodes and the lymph node ratio (LNR) decreased from 2000 to 2007. A lymph node yield of 12 or more was not associated with an increased probability of positive lymph nodes in a multivariable logistic regression analysis.
conclusionMore radical surgery and dedicated pathologists and the use of the GEWF solvent significantly increased the lymph node yield but did not upstage patients from TNM stage II to III.
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