A new device for the identification of lymph nodes at lung cancer surgery

Molnár, Tamás

doi:10.1016/j.ejcts.2006.11.047

Cited by 12 publications

(14 citation statements)

References 5 publications

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“…26-29 Other studies show a difference in survival between subsets of patients with pN1 who have varying numbers of lymph node metastasis. 13,16 Because the opportunity for quality improvement in nodal staging accuracy exists in surgical practice (the hilar and mediastinal nodal harvest, 18 clarity of specimen labeling, 18,30 security of specimen transfer from the operating room to the pathology laboratory), 31 as well as pathology practice, it is desirable to implement interventions that target practice in both areas, as we have done. However, it is also important to clarify the contribution of each intervention.…”

Section: Discussionmentioning

confidence: 99%

The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens

Osarogiagbon¹,

Eke²,

Sareen³

et al. 2014

Annals of Diagnostic Pathology

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Introduction Although thorough pathologic nodal staging provides the greatest prognostic information in patients with potentially curable non-small cell lung cancer, N1 nodal metastasis is frequently missed. We tested the impact of corrective intervention with a novel pathology gross dissection protocol on intrapulmonary lymph node retrieval. Methods Retrospective review of consecutive lobectomy, or greater, lung resection specimens over a period of 15 months before and 15 months after training Pathologist's Assistants on the novel dissection protocol. Results 141 specimens were examined before and 121 specimens after introduction of the novel dissection protocol. The median number of intrapulmonary lymph nodes retrieved increased from 2 to 5 (p<.0001), and the 75th – 100th percentile range of detected intrapulmonary lymph node metastasis increased from 0 – 5 to 0 – 17 (p=.0003). In multivariate analysis, the extent of resection, examination period (pre- or post-intervention), and pathologic N1 (vs. N0) status were most strongly associated with a higher number of intrapulmonary lymph nodes examined. Conclusions A novel pathology dissection protocol is a feasible and effective means of improving the retrieval of intrapulmonary lymph nodes for examination. Further studies to enhance dissemination and implementation of this novel pathology dissection protocol are warranted.

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Section: Discussionmentioning

confidence: 99%

The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens

Osarogiagbon¹,

Eke²,

Sareen³

et al. 2014

Annals of Diagnostic Pathology

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“…For surgeons, this means, foremost, removing all hilar and mediastinal lymph nodes as is technically feasible ( Table 1). Several intraoperative methods have been proposed for surgeons to aid in complete sampling of lymph nodes from predetermined lymph node stations as defined by the International Association for the Study of Lung Cancer (IASLC) lymph node station nomenclature [20,21]. It would be helpful to establish a standardized routine for handling the lymph nodes removed by dissection at the time of thoracotomy.…”

Section: For Related Articles See Pages 363 and 448mentioning

confidence: 99%

Node Doubt: Rigorous Surgical Nodal Procurement Combined With Thorough Pathologic Evaluation Improves Non-Small Cell Lung Carcinoma Staging Accuracy

Butnor

Asamura

Travis

2016

The Annals of Thoracic Surgery

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“…Pre-labeled lymph node specimen collection kits significantly improve the surgical collection of mediastinal lymph nodes and the quality of nodal staging [11–13]. How these kits influence the consistency of identification of mediastinal dissection procedure by different observers is unclear.…”

Section: Introductionmentioning

confidence: 99%

Audit of Lymphadenectomy in Lung Cancer Resections Using a Specimen Collection Kit and Checklist

Osarogiagbon¹,

Sareen²,

Eke³

et al. 2015

The Annals of Thoracic Surgery

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Background Audits of operative summaries and pathology reports reveal wide discordance in identifying the extent of lymphadenectomy performed (the communication gap). We tested the ability of a pre-labeled lymph node specimen collection kit and checklist to narrow the communication gap between operating surgeons, pathologists, and auditors of surgeons’ operation notes. Methods We conducted a prospective single cohort study of lung cancer resections performed with a lymph node collection kit from November 2010 to January 2013. We used the kappa statistic to compare surgeon claims on a checklist of lymph node stations harvested intraoperatively, to pathology reports, and an independent audit of surgeons’ operative summaries. Lymph node collection procedures were classified into 4 groups based on the anatomic origin of resected lymph nodes: mediastinal lymph node dissection, systematic sampling, random sampling and no sampling. Results From the pathology report, 73% of 160 resections had a mediastinal lymph node dissection or systematic sampling procedure, 27% had random sampling. The concordance with surgeon claims was 80% (kappa statistic 0.69 [CI 0.60 – 0.79]). Concordance between independent audits of the operation notes and either the pathology report (kappa 0.14 [0.04 – 0.23]), or surgeon claims (kappa 0.09 [0.03 – 0.22]), was poor. Conclusion A pre-labeled specimen collection kit and checklist significantly narrowed the communication gap between surgeons and pathologists in identifying the extent of lymphadenectomy. Audit of surgeons’ operation notes did not accurately reflect the procedure performed, bringing its value for quality improvement work into question.

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A new device for the identification of lymph nodes at lung cancer surgery

Cited by 12 publications

References 5 publications

The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens

The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens

Node Doubt: Rigorous Surgical Nodal Procurement Combined With Thorough Pathologic Evaluation Improves Non-Small Cell Lung Carcinoma Staging Accuracy

Audit of Lymphadenectomy in Lung Cancer Resections Using a Specimen Collection Kit and Checklist

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