Trends in lymph node excision and impact of positive lymph node ratio in patients with colectomy for primary colon adenocarcinoma: Population based study 1988 to 2011

Garcia, Brandon; Guzmán, Carlos; Johnson, Christopher; Hellenthal, Nicholas J.; Monie, Daphne; Monzon, Jose R.

doi:10.1016/j.suronc.2016.05.013

Cited by 23 publications

(22 citation statements)

References 16 publications

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“…This value is critical given the recent findings of Gracia et al on the trends of positive LNR in patients with colectomy. They reported a positive LNR starting at 0.16 increased the cancer specific mortality by 15.7% while a ratio greater than 0.21 increased the overall mortality by 16.6% in a large population base study [11]. Because 80.1% of our OC and 77.1% of our NOC patients were below LNR of 0.24 using a quartile distribution, it is difficult to determine whether a similar trend would be seen in our cohort of patients.…”

Section: Discussionmentioning

confidence: 73%

Prognostic Impact of Lymph Node Ratio in Obstructive Colorectal Cancer

Clark¹

2017

J Can Epi Treat

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Background: An estimated 15% to 20% of patients with colorectal cancers present with intestinal obstruction. Although colorectal cancer patients with lower lymph node ratios (LNR) have been shown to have a higher overall survival and disease free survival, this finding has not been clearly defined in patients with obstructive colorectal cancer. Here, we examine the impact of LNR on oncologic outcomes of colorectal cancer patients with and without obstruction.

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Section: Discussionmentioning

confidence: 73%

Prognostic Impact of Lymph Node Ratio in Obstructive Colorectal Cancer

Clark¹

2017

J Can Epi Treat

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“…Increase in number of LNs removal suggests improvement in tumour clearance and decrease in metastatic spread [2]. Therefore, excision of sufficient number of LNs during resection of colorectal cancer is crucial.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have shown an inverse correlation between the number of positive LNs and survival. There is independent and positive association between an increase in the number of LNs excision and improved survival rate for both node-positive and node-negative patients, while a higher lymph node ratio (LNR) is correlated with increased mortality, overall and cancer-specific [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…An excision of 12 or more LNs is considered as the current standard of treatment in colorectal carcinomas [2,4]. The National Comprehensive Cancer Network (NCCN) and the College of American Pathologists, and the American Joint Committee on Cancer (AJCC) suggest a minimum of 12 LNs to establish the colorectal staging [19].…”

Section: Introductionmentioning

confidence: 99%

“…The National Comprehensive Cancer Network (NCCN) and the College of American Pathologists, and the American Joint Committee on Cancer (AJCC) suggest a minimum of 12 LNs to establish the colorectal staging [19]. The probability of harvesting more LNs has been predicted by a more contemporary year of operation, increased tumour stage, higher tumour grade, younger patients and non-Caucasian ethnicity [2]. Harvesting fewer LNs has been associated with the year of operation, early tumour stage, elder patients and the operation approach [4].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic colectomies associated with decreased retrieval of 12 or more lymph nodes compared to open in elective colon cancer surgery

Puckett

Mitchell

Pham

2019

ecancer

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Background: Colorectal cancer is the third most commonly diagnosed cancer worldwide. Lymph node (LN) retrieval is a key factor for pathologic staging and prognosis of colorectal cancer. Increase in number of LNs removal suggests improvement in tumour clearance and decrease in metastatic spread. Studies have suggested that excising 12 or more LNs during colectomy in patients with colon cancer is associated with improved survival. To date, there have been no studies to determine whether minimally invasive surgery affects the ability to retrieve 12+ LNs in elective colon cancer surgery. Therefore, we elected to determine whether a difference exists on the ability to retrieve 12+ nodes in elective colon cancer colectomies performed open versus laparoscopic. Methods:The National Surgical Quality Improvement Program (NSQIP) Procedure Specific Colectomy database was analysed for the year 2014-2015. Inclusion criteria were colon cancer (ICD-9 Code 153.9), age greater than 18 years. Exclusion criteria were missing data. Data abstracted included patient demographics, type of operation performed and number of LNs retrieved. The patients were categorised based on their elective colon cancer colectomies such as laparoscopic or open. Binary logistic regression was used to identify confounding variables in the retrieval of 12+ LNs. Results:After accounting for missing cases, a total of 18,792 patients with a diagnosis of colon cancer were analysed. Twelve or more LNs were retrieved in 88% (16,538) of patients, Among them, 2,516 patients underwent laparoscopic colectomy and 5,284 patients underwent open colectomy. The difference was not statistically significant for the average number of LNs retrieved among both the groups. Open operative approach compared to the laparoscopic approach was associated with 15% greater odds of retrieval of >12 LNs (OR 1.148; 95% CI (1.035-1.272); p = 0.008). Conclusion:The majority of colectomies such as open or laparoscopic are able to retrieve 12 or more LNs. However, there are greater odds of retrieving more than 12 LNs with the open approach compared to the laparoscopic approach. By allowing for more LN retrieval, open colectomies suggest improvement in tumour clearance and decrease metastatic spread. Additional research is needed to further investigate the specific factors influencing the ability to retrieve an adequate number of LNs, such as viewing angles provided with an open approach versus laparoscopic approach.

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EWS–FLI1‐targeting peptide identifies Ewing sarcoma tumor boundaries and lymph node metastasis via near‐infrared imaging

et al. 2021

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Ewing sarcoma (ES) is one of the most aggressive types of pediatric tumors. The lack of tools for the identification of ES has largely hindered clinical diagnosis and the improvement of treatment. To address this challenge, we synthesized a near-infrared (NIR) fluorescent probe (CS2-N-E9R) that targets the ES-specific fusion protein EWS-FLI1 (E/F). This probe exhibited specific and high binding affinity to E/F. Further studies in animal models showed that CS2-N-E9R can be used to identify the boundaries of ES and lymph node metastases under a complex biological environment. These results demonstrate that CS2-N-E9R is a promising probe for early diagnosis and surgical guidance of ES through molecularly targeted NIR imaging.

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Trends in lymph node excision and impact of positive lymph node ratio in patients with colectomy for primary colon adenocarcinoma: Population based study 1988 to 2011

Cited by 23 publications

References 16 publications

Prognostic Impact of Lymph Node Ratio in Obstructive Colorectal Cancer

Prognostic Impact of Lymph Node Ratio in Obstructive Colorectal Cancer

Laparoscopic colectomies associated with decreased retrieval of 12 or more lymph nodes compared to open in elective colon cancer surgery

EWS–FLI1‐targeting peptide identifies Ewing sarcoma tumor boundaries and lymph node metastasis via near‐infrared imaging

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