Featured Research

from universities, journals, and other organizations

Evaluating More Lymph Nodes May Not Improve Identification Of Late-stage Colorectal Cancer

Date:
August 26, 2009
Source:
JAMA and Archives Journals
Summary:
Surgically removing and evaluating an increasing number of lymph nodes does not appear to identify a greater number of patients with stage III colorectal cancer, according to a new report.

Surgically removing and evaluating an increasing number of lymph nodes does not appear to identify a greater number of patients with stage III colorectal cancer, according to a report in the July issue of Archives of Surgery, one of the JAMA/Archives journals.

Related Articles


Colorectal cancer is the third most common type of cancer and the third leading cause of cancer-related death in the United States, according to background information in the article. More than 80 percent of newly diagnosed colorectal cancer patients will have locoregional disease (limited to a small region) and will be offered surgery that may cure their illness. The status of lymph nodes near the cancer has been recognized as the most powerful prognostic factor for recurrence and survival in these patients.

"Accurate lymph node staging also is important for determining prognosis and the need for adjuvant chemotherapy," the authors write. "In addition, lymphadenectomy [lymph node removal] may be therapeutic; several studies have shown a positive association between the number of lymph nodes removed and survival for patients with negative and positive lymph nodes."

In 1990, the World Congress of Gastroenterology first proposed a minimum threshold of 12 lymph nodes to be removed during surgery for colorectal cancer. This benchmark has since been adopted as a quality measure for surgical practice by multiple organizations. Sachin S. Kukreja, M.D., and colleagues at Rush North Shore Medical Center (now Skokie Hospital, NorthShore University HealthSystem), Skokie, Ill., and Rush University Medical Center and Rush Medical College, Chicago, in late 2004 began a multidisciplinary institutional initiative to increase the number of lymph nodes removed during colorectal cancer surgery. The effort involved discussing unacceptably low lymph node counts and reviewing the rationale for increased lymph node evaluation at multidisciplinary cancer committee meetings, along with a program of institutional awareness of the issue and a change in pathologists' lymph node assessment technique.

The researchers then evaluated 701 consecutive colorectal cancer cases treated with surgery from 1996 through 2007. The initiative appeared successful in increasing the numbers of lymph nodes removed—when patients operated on in January 2005 or after were compared with those who had surgery before the initiative began, both the average number of lymph nodes removed (17.3 vs. 12.8) and the percentage of patients who had at least 12 lymph nodes removed (71.6 percent vs. 53 percent) increased.

However, the proportion of patients diagnosed with stage III colorectal cancer did not change, with 204 of 553 (36.9 percent) of the earlier cases and 48 of 148 (32.4 percent) of the late cases having positive lymph nodes.

"Overall, our improvement in lymph node yield demonstrates the value and impact of communication through a multidisciplinary initiative engaged in adherence to recommended standards and improving quality of care," the authors conclude. However, "our data suggest that mandatory harvest of a minimum of 12 lymph nodes as a quality indicator or performance measure appears unfounded."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Sachin S. Kukreja; Enrique Esteban-Agusti; Jose M. Velasco; Tina J. Hieken. Increased Lymph Node Evaluation With Colorectal Cancer Resection. Archives of Surgery, 2009; [link]

Cite This Page:

JAMA and Archives Journals. "Evaluating More Lymph Nodes May Not Improve Identification Of Late-stage Colorectal Cancer." ScienceDaily. ScienceDaily, 26 August 2009. <www.sciencedaily.com/releases/2009/07/090720163546.htm>.
JAMA and Archives Journals. (2009, August 26). Evaluating More Lymph Nodes May Not Improve Identification Of Late-stage Colorectal Cancer. ScienceDaily. Retrieved November 24, 2014 from www.sciencedaily.com/releases/2009/07/090720163546.htm
JAMA and Archives Journals. "Evaluating More Lymph Nodes May Not Improve Identification Of Late-stage Colorectal Cancer." ScienceDaily. www.sciencedaily.com/releases/2009/07/090720163546.htm (accessed November 24, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, November 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com
Winter Can Cause Depression — Here's How To Combat It

Winter Can Cause Depression — Here's How To Combat It

Newsy (Nov. 23, 2014) Millions of American suffer from seasonal depression every year. It can lead to adverse health effects, but there are ways to ease symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins