Assessing the Quality of Colorectal Cancer Staging

Abstract

Despite significant differences in the mean number of nodes examined between medical centers, the overall survival in patients with node-negative colorectal cancer in the 3 medical centers was not statistically different (P =.79). The criterion of examining 14 or more nodes distinguished between individuals at low risk for recurrence and those at increased risk. Conclusions: Variability exists between medical centers in the pathological analysis of colorectal cancer specimens. However, within an institution, examining a mean of 14 or more nodes accurately stages apparently nodenegative colorectal cancer and accurately predicts outcome.

Surgery for Colorectal Cancer in Sri Lanka: Open to Laparoscopy

“…In our study group the proportion of rectal cancer (RC) was higher (40.2%) than reported (15.7 to 38.7%) in other studies [10,11,18]. Further, about 80 % of CRC in our patients was located on the left side making it accessible even with a flexible sigmoidoscope.…”

“…In a large study of 3557 patients mean LN harvest was 13 (1 to 53), (37); in our patients we could harvest only a median of 8 (1 to 41) nodes. Lymph node positive ratio (15.1%) was also lower than reported (49.7 %) [18,29].…”

Clinical application of sentinel lymph node mapping in colon cancer:in vivovs.ex vivotechniques

“…To improve the nodal analysis, several methods have been introduced, such as SLN evaluation, IHC staining, and fat clearing technique. Fat clearing technique is time-consuming and difficult to perform in routine practice [21]. On the contrary, SLN mapping is a simple and inexpensive technique to improve the staging in a clinical setting.…”

Neoadjuvant Chemoradiation for Rectal Cancer Reduces Lymph Node Harvest in Proctectomy Specimens

“…[18][19][20][21][22][23][24] Despite these controversies, in an effort led by the American College of Surgeons (ACoS) Commission on Cancer (CoC), in conjunction with the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN), the National Quality Forum (NQF) endorsed that at least 12 lymph nodes should be resected in all patients undergoing surgery for colorectal cancer to assure quality of care. 25 Surgeon performance measures used in Medicare pay-for-performance programs must be evidence-based, broadly accepted, clinically relevant, and in the case of lymphadenectomy for colorectal cancer, take into consideration the factors that affect lymph node harvesting such as chemoradiation, age, location of the tumor, and geographic location.…”