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Factors affecting lymph node yield from patients undergoing colectomy for cancer.
Zubin M Bamboat1, Danielle Deperalta, Abdulmetin Dursun
1Division of Gastrointestinal Surgery, Colon and Rectal Surgery Program, Massachusetts General Hospital, Boston, MA 02114, USA.
International Journal of Colorectal Disease
|May 17, 2011
Summary
Colon cancer staging relies on lymph node (LN) yield. Pathologists in their first year of training reported significantly more LNs than experienced ones, impacting cancer staging quality.
Area of Science:
- Oncology
- Surgical Pathology
- Cancer Staging
Background:
- Lymph node (LN) yield is crucial for accurate colon cancer staging.
- It serves as a key indicator for surgical quality assessment.
- Factors influencing LN harvest require thorough investigation.
Purpose of the Study:
- To investigate the impact of pathologists' training level on lymph node harvest in colon cancer.
- To identify factors affecting lymph node yield during colectomy.
Main Methods:
- Retrospective review of 137 patients undergoing elective colectomy for adenocarcinoma.
- Analysis of surgeon, patient, and pathologist-derived factors.
- Logistic regression used to identify independent variables impacting LN yield.
Main Results:
- Lymph node yield was comparable between open and laparoscopic colectomies (21 vs. 23, p=0.54).
- Nodal counts were not significantly affected by tumor location or surgeon specialty.
- Pathology residents in their first year (PGY-1) reported significantly more LNs than those with 2+ years of training (24 vs. 19, p=0.02).
- Pathologist's training year was the sole significant predictor of LN yield (OR=5.28, p=0.0001).
Conclusions:
- Lymph node retrieval in colon cancer cases is inversely associated with the interpreting pathologist's training level.
- This finding suggests a potential impact on the reliability of colon cancer staging based on pathology resident experience.
