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Updated: Jun 12, 2026
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Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
Meeting the 12 lymph node (LN) benchmark in colon cancer
A Rajput1, D Romanus, M R Weiser
1Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA. arajput@salud.unm.edu
Journal of Surgical Oncology
|June 26, 2010
Summary
Colorectal cancer quality metrics show that National Comprehensive Cancer Network (NCCN) centers evaluate at least 12 lymph nodes (LN) in 92% of patients, significantly higher than the 58% seen in the Surveillance, Epidemiology, and End Results (SEER) program.
Area of Science:
- Oncology
- Surgical Quality Metrics
- Cancer Care Research
Background:
- Lymph node (LN) evaluation is a critical quality metric in colon cancer care.
- The benchmark of examining 12 or more LN aims to improve staging and treatment decisions.
- Assessing adherence to this metric is essential for quality improvement initiatives.
Purpose of the Study:
- To compare the achievement of the 12 LN examination benchmark at National Comprehensive Cancer Network (NCCN) centers versus a US population-based sample.
- To identify factors influencing the evaluation of at least 12 LN in colon cancer patients.
Main Methods:
- Retrospective analysis of 718 patients with stage I-III colon cancer treated at NCCN centers.
- Comparison with 12,845 stage I-III colon cancer patients from a Surveillance, Epidemiology, and End Results (SEER) region.
- Multivariate logistic regression used to identify factors associated with evaluating ≥12 LN.
Main Results:
- 92% of NCCN patients had ≥12 LN evaluated, compared to 58% of SEER patients.
- Factors associated with not meeting the 12 LN target at NCCN centers included left-sided tumors, stage I disease, and BMI >30.
- Significant disparity in lymph node evaluation rates between NCCN centers and the general US population.
Conclusions:
- The ≥12 LN evaluation benchmark is nearly universally met at NCCN centers.
- A substantial gap exists in lymph node evaluation rates between NCCN centers and SEER data.
- Further research will correlate LN evaluation rates with recurrence and survival to inform cancer control priorities.
