Related Experiment Video
Updated: Jul 20, 2026
10:38
DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
Published on: February 1, 2020
Pathology practice patterns affect lymph node evaluation and outcome of colon cancer: a population-based study
V E Lemmens1, I van Lijnschoten, M L Janssen-Heijnen
1Department of Research, Comprehensive Cancer Centre South, Eindhoven, USA. research@ikz.nl
Summary
Pathology departments show significant variation in examining lymph nodes for colon cancer patients. This impacts cancer staging and patient survival, highlighting the need for standardized nodal assessment.
Area of Science:
- Oncology
- Surgical Pathology
- Cancer Epidemiology
Background:
- Significant variation exists in the number of lymph nodes examined for colon cancer patients across different settings.
- This variability has been observed between patients, hospitals, and geographical regions.
Purpose of the Study:
- To investigate the factors influencing the variation in lymph node evaluation for colon cancer patients.
- To determine the relationship between lymph node assessment variation and patient survival.
Main Methods:
- A cohort of 2168 patients with stage I-III colon carcinoma diagnosed between 1999-2002 was analyzed.
- Determinants of lymph node evaluation and survival were assessed, focusing on inter-departmental variation within pathology departments.
Main Results:
- A median of six lymph nodes were examined per specimen, with departmental medians ranging from three to eight.
- Pathology department variation persisted after adjustments, affecting N+ tumor proportions (29%-41%) and survival outcomes.
- Increased lymph node examination correlated positively with survival, and node-negative patient survival varied significantly between departments (HR up to 1.5).
Conclusions:
- Substantial variation in lymph node evaluation exists among pathology departments.
- This variation leads to disparities in cancer staging and impacts patient survival rates.
- Intervention strategies should prioritize standardizing lymph node assessment in colon cancer care.
