Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Mar;4(2):55-8.
doi: 10.1200/JOP.0822001.

Targeting Lymph Node Retrieval and Assessment in Stage II Colon Cancer: A Quality Outcome Community-Based Cancer Center Study

Thomas Grote  1 , Amy H Hughes, Cathy C Rimmer, Dale A Less, Amy P Abernethy; Multidisciplinary Gastrointestinal Tumor Board, Derrick L. Davis Forsyth Regional Cancer Center
Affiliations

Targeting Lymph Node Retrieval and Assessment in Stage II Colon Cancer: A Quality Outcome Community-Based Cancer Center Study

Thomas Grote et al. J Oncol Pract. 2008 Mar.

Abstract

Purpose: Adequate lymph node evaluation is required for the proper staging of colon cancer. The current recommended number of lymph nodes that should be retrieved and assessed is 12.

Methods: The multidisciplinary Gastrointestinal Tumor Board at the Derrick L. Davis Forsyth Regional Cancer Center reviewed and recommended that a minimum of 12 lymph nodes be examined in all cases of colon cancer to ensure proper staging. This recommendation occurred at the end of the first quarter of 2005. To ensure this new standard was being followed, an outcomes study looking at the number of lymph nodes evaluated in stage II colon cancer was initiated. All patients with stage II colon cancer diagnosed between 2004 and 2006 were reviewed.

Results: There was a statistically significant improvement in the number of stage II colon cancer patients with 12 or more lymph nodes evaluated. Before the Gastrointestinal Tumor Board's recommendation, 49% (40 out of 82 patients) had 12 or more lymph nodes sampled. The median number of lymph nodes evaluated was 11. After the Gastrointestinal Tumor Board's recommendation, 79% (70 out of 88 patients) had 12 or more lymph nodes sampled. The median number of lymph nodes was 16.

Conclusion: Multidisciplinary tumor boards can impact the quality of care of patients as demonstrated in this study. Although we do not yet have survival data on these patients, based on the previous literature referenced in this article, we would expect to see an improvement in survival rates in patients with 12 or more nodes retrieved and assessed.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Percent of stage II colon cancer cases by cancer location at D.L. Davis Forsyth Regional Cancer Center from 2004 to 2006. Group A cases include 2004-1Q05 and Group B cases include 2Q05-2006.
Figure 2.
Figure 2.
Number of nodes examined in stage II colon cancer cases at D.L. Davis Forsyth Regional Cancer Center from 2004 to 2006. Group A cases include 2004-1Q05 and Group B cases include 2Q05-2006.
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Ward E, et al: Cancer statistics 2007. CA Cancer J Clin 57:43-66, 2007 - PubMed
    1. Adjuvant! Online, Spring 2007. www.adjuvantonline.com
    1. Compton CC, Fielding LP, Burgart LJ, et al: Prognostic factors in colorectal cancer College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 124:979-994, 2000 - PubMed
    1. AJCC Cancer Staging Manual in Greene FL, Page DL, Fleming ID, et al (eds.).ed 6. New York, NY, Springer Verlag, 2002
    1. Nelson H, Petrelli N, Carlin A, et al: Guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst 93:583-596, 2001 - PubMed