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A half a node or a whole node: a comparison of methods for submitting lymph nodes
T H Niemann1, A G Yilmaz, W L Marsh
1Department of Pathology, Ohio State University Hospital, Columbus, USA.
American Journal of Clinical Pathology
|May 12, 1998
Summary
Submitting all lymph nodes from dissections identified additional metastases in 7 patients, potentially altering cancer staging and therapy. The cost of this comprehensive approach was $5,935.62.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Lymph node status is crucial for cancer prognosis and treatment decisions.
- Current practices lack consensus on the complete submission of lymph nodes from dissections.
Purpose of the Study:
- To evaluate the diagnostic yield and cost-effectiveness of submitting all lymph nodes from dissections.
- To determine if processing additional tissue blocks from larger lymph nodes identifies previously undetected metastases.
Main Methods:
- A 4-month prospective study involving 149 patients undergoing lymph node dissections.
- All lymph nodes were submitted in their entirety, with larger nodes sectioned systematically.
- Analysis of additional tissue blocks for metastases and associated costs.
Main Results:
- A total of 2,915 lymph nodes were processed, yielding 808 additional tissue blocks.
- Nine additional metastases were identified in 7 patients from these extra blocks.
- In 2 patients, these findings altered the neoplasm's stage and potentially influenced therapy.
Conclusions:
- Complete lymph node submission can identify additional metastases, impacting cancer staging and treatment.
- The cost-effectiveness of this comprehensive approach requires consideration by individual pathology practices.