A Predictive Model for Lymph Node Yield in Colon Cancer Resection Specimens

Abstract

Multiple tumor and surgical factors are associated with lymph node yields in colon specimens. A standard minimum of lymph nodes may not be applicable to all colon cancer resections.

Influence of Microsatellite Instability and KRAS and BRAF Mutations on Lymph Node Harvest in Stage I–III Colon Cancers

“…Each factor likely influences the LN sample to a modest, yet significant, degree, as demonstrated by the multivariable modeling in this series. This observation is in accordance with a previous study, in which four factors collectively explained 19% of the overall variation in the prediction model (35). Genetic features should be considered together with other clinicopathological factors when assessing node count after surgery for colon cancer.…”

Effect of preoperative colonoscopic tattooing on lymph node harvest in T1 colorectal cancer

“…In addition to localization by PCT, several authors recently reported that PCT could increase the number of nodes examined [6][7][8]. The reason for increased lymph node yield after tattooing was attributed to the fact that India ink-containing lymph nodes can be more easily detected by the surgeon or pathologist (Fig.…”

Lymph Node Yield and Oncologic Outcome after Colorectal Cancer Resection

“…Age, tumor size, depth of penetration, location, use of radiation, and gene mutations have been associated with lymph node yield. 4,[7][8][9] These findings suggest a host-tumor interaction that may result in stimulation of the immune system and, as a consequence, larger and thus easier to identify mesenteric lymph nodes. It does not stretch the imagination to consider that such an interaction would have implications for tumor recurrence.…”

“…Many protocols have been advocated to maximize nodal yield, including the use of in vivo or ex vivo dye injection, fat clearance, and multiple rounds of gross examination. [4][5][6] However, one cannot categorically state that specific surgical or pathologic methods are necessary to achieve such yields in all cases, because this has not been adequately studied in a prospective, controlled fashion.…”

“…In a study, conducted by this author, of a consecutive series of surgical specimens at a single center, apical vessel ligation was not universally performed; yet 96 % of the specimens were found to contain more than 12 lymph nodes. 4 Meticulous surgical technique and careful pathologic examination is paramount to achieve high lymph node yields. Many protocols have been advocated to maximize nodal yield, including the use of in vivo or ex vivo dye injection, fat clearance, and multiple rounds of gross examination.…”