PMID- 17577036
OWN - NLM
STAT- MEDLINE
DCOM- 20070720
LR  - 20070619
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 25
IP  - 18
DP  - 2007 Jun 20
TI  - Identifying stage III colorectal cancer patients: the influence of the patient, 
      surgeon, and pathologist.
PG  - 2573-9
AB  - PURPOSE: Nodal yields from resected colorectal cancers vary greatly. This study 
      sought to determine what patient, tumor, and management factors influence the 
      number of nodes retrieved and to determine if the extent of lymphadenectomy 
      affects stage allocation and influences survival. PATIENTS AND METHODS: 
      Retrospective study of the nodal yields of 7,062 surgically resected colorectal 
      cancer patients for whom colorectal pathology minimum data sets had been 
      collected. The percentage of patients diagnosed as stage III was compared across 
      nodal yield categories. A threshold for an adequate lymphadenectomy was defined 
      as retrieval of 12 nodes. Binary logistic regression was used to determine 
      factors associated with obtaining an adequate lymphadenectomy. RESULTS: Median 
      nodal yields increased over the study period from 7 (interquartile range [IQR], 4 
      to 11) in 1995 to 13 (IQR 8 to 19) in 2003. There was no difference in yield by 
      cancer site or sex, but yields were lower in older patients. Yields increased 
      with increasing local invasion and stage of tumor. The percentage of patients 
      diagnosed as stage III increased as yields increased. Five-year survival was 
      lower in those patients who did not have an adequate lymphadenectomy. Adequate 
      lymphadenectomy was significantly more likely in patients with advanced tumors 
      and when the surgery and pathology was undertaken by a specialist. Older patients 
      were significantly less likely to receive an adequate lymphadenectomy. 
      CONCLUSION: Variations in nodal yield are due to idiosyncratic patient and tumor 
      characteristics and differences in the quality of surgery and pathology 
      undertaken. Adequate lymphadenectomy is essential to ensure correct stage 
      allocation and optimal survival.
FAU - Morris, Eva Judith Ann
AU  - Morris EJ
AD  - Cancer Epidemiology Group, Centre for Epidemiology and Biostatistics, University 
      of Leeds, United Kingdom. eva.morris@nycris.leedsth.nhs.uk
FAU - Maughan, Nicola Joanne
AU  - Maughan NJ
FAU - Forman, David
AU  - Forman D
FAU - Quirke, Philip
AU  - Quirke P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/*pathology/surgery
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Lymph Node Excision
MH  - *Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Predictive Value of Tests
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Statistics, Nonparametric
EDAT- 2007/06/20 09:00
MHDA- 2007/07/21 09:00
CRDT- 2007/06/20 09:00
PHST- 2007/06/20 09:00 [pubmed]
PHST- 2007/07/21 09:00 [medline]
PHST- 2007/06/20 09:00 [entrez]
AID - 25/18/2573 [pii]
AID - 10.1200/JCO.2007.11.0445 [doi]
PST - ppublish
SO  - J Clin Oncol. 2007 Jun 20;25(18):2573-9. doi: 10.1200/JCO.2007.11.0445.