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Related Experiment Videos

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
PubMed
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.

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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:

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  • 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.