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Related Experiment Video

Updated: Feb 28, 2026

DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
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Institutional variants for lymph node counts after pancreatic resections.

Roderich E Schwarz1

  • 1Department of Surgery, Indiana University School of Medicine, South Bend; Goshen Center for Cancer Care, Goshen, IN, USA.

American Journal of Surgery
|June 17, 2017
PubMed
Summary

Lymph node counts after pancreatectomy vary significantly between institutions. Standardizing pathologic processing is crucial for using lymph node counts as a quality metric in pancreatic cancer surgery.

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Area of Science:

  • Surgical Oncology
  • Pathology
  • Quality Metrics

Background:

  • Lymph node (LN) counts are considered a quality metric for pancreatic cancer surgery.
  • Variability in LN counts may impact the reliability of this metric.

Purpose of the Study:

  • To identify predictors of lymph node counts in patients undergoing pancreatectomy.
  • To assess the variability of lymph node counts across different institutions.

Main Methods:

  • Analysis of prospectively collected data from a single surgeon's pancreatectomy experience.
  • Inclusion of 315 consecutive patients, with a focus on 239 diagnosed with cancer.
  • Data collection across four different tertiary cancer center settings.

Main Results:

  • Mean total lymph node counts differed significantly between institutions for both malignant and benign diseases (p < 0.0001).
  • The proportion of cancer patients with at least 15 lymph nodes reported varied widely by institution (34-92%, p < 0.0001).

Conclusions:

  • Lymph node counts exhibit significant institutional variability.
  • Standardization of pathologic processing is essential for adopting lymph node counts as a reliable quality metric for pancreatic cancer resections.