Clinical and pathologic factors that predict lymph node yield from surgical specimens in colorectal cancer: A population-based study Journal Article

Authors: Chou, J. F.; Row, D.; Gonen, M.; Liu, Y. H.; Schrag, D.; Weiser, M. R.
Article Title: Clinical and pathologic factors that predict lymph node yield from surgical specimens in colorectal cancer: A population-based study
Abstract: BACKGROUND: The National Quality Forum endorses the recommendation of examining at least 12 lymph nodes (LNs) from colorectal cancer (CRC) specimens. However, heterogeneity in LN harvest exists. The objective of this study was to investigate the clinicopathologic factors that influence LN yield. METHODS: The authors used the Surveillance, Epidemiology, and End Results database to identify patients who were diagnosed with stage I, II, and III CRC between 1994 and 2005. Poisson regression was used to model the number of LNs examined as a function of individual clinicopathologic factors, including age, sex, race, year of diagnosis, geographic region, anatomic site, preoperative radiation, tumor size, tumor classification, tumor differentiation, and LN positivity. RESULTS: In total, 153,483 patients with CRC were identified. The mean number of LNs examined (± standard deviation) was 12 (±9.3). Separate multivariate analyses revealed that age, year of diagnosis, tumor size, and tumor classification were significant predictors of LN yield for colon and extraperitoneal rectal cancers (P < .01 for all covariates). Tumor location and radiotherapy were significant predictors of LN yield in patients with colon cancer and rectal cancer, respectively. Overall LN yields increased between 2% and 3% annually. CONCLUSIONS: Despite the increasing yields observed over time, patients with rectal cancer and older patients who had distally located, early colon cancer were less likely to meet the benchmark yield of 12 LNs. Further investigation into how LN yield is influenced by alterable factors, such as the extent of mesenteric resection and the pathologic technique, as well as nonalterable factors, such as patient age and tumor location, may reveal innovative ways to improve current staging methods. © 2010 American Cancer Society.
Keywords: adult; human tissue; aged; middle aged; major clinical study; cancer radiotherapy; lymph node metastasis; staging; lymph nodes; lymphatic metastasis; neoplasm staging; colorectal cancer; colonic neoplasms; age factors; prediction; groups by age; time factors; colorectal neoplasms; population research; early cancer; colon cancer; lymph node; cancer size; seer program; preoperative treatment; cancer classification; epidemiology; rectal neoplasms; rectum cancer; lymphatic system examination; surveillance; geographic distribution; clinicopathologic factors; end results; lymph node yield
Journal Title: Cancer
Volume: 116
Issue: 11
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2010-06-01
Start Page: 2560
End Page: 2570
Language: English
DOI: 10.1002/cncr.25032
PUBMED: 20499400
PROVIDER: scopus
PMCID: PMC4067456
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: CANCA" - "Source: Scopus"
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MSK Authors
  1. Joanne Fu-Lou Chou
    153 Chou
  2. Mithat Gonen
    701 Gonen
  3. Yihai Liu
    5 Liu
  4. Deborah Schrag
    137 Schrag
  5. David Row
    3 Row
  6. Martin R Weiser
    338 Weiser