Better retrieval of lymph nodes in colorectal resection specimens by pathologists’ assistants

Kuijpers, Chantal C H J; Slooten, Henk Jan Van; Schreurs, W. H.; Moormann, G. R. H. M.; Abtahi, Mohammad‐Ali; Slappendel, A; Cliteur, Vincent; Diest, Paul J. van; Jiwa, Natasha

doi:10.1136/jclinpath-2012-201089

Cited by 31 publications

(16 citation statements)

References 40 publications

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“…Currently data similar to ours has been reported in literature if it is true that in the US reports published between 2005 and 2010 revealed that lymphadenectomy was still considered inadequate in 48 to 63% of cases. 37,38 Similarly in Germany in 2009, the Dutch Surgical Colorectal Audit 39 reported that in 73% of colon cancers and 58% of rectum cancers, the number of lymph nodes examined was 10.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Destri

Rubino

Latino

et al. 2015

International Surgery

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To evaluate whether, in a sample of patients radically treated for colorectal carcinoma, the preoperative determination of the carcinoembryonic antigen (p-CEA) may have a prognostic value and constitute an independent risk factor in relation to disease-free survival. The preoperative CEA seems to be related both to the staging of colorectal neoplasia and to the patient's prognosis, although this-to date-has not been conclusively demonstrated and is still a matter of intense debate in the scientific community. This is a retrospective analysis of prospectively collected data. A total of 395 patients were radically treated for colorectal carcinoma. The preoperative CEA was statistically compared with the 2010 American Joint Committee on Cancer (AJCC) staging, the T and N parameters, and grading. All parameters recorded in our database were tested for an association with disease-free survival (DFS). Only factors significantly associated (P , 0.05) with the DFS were used to build multivariate stepwise forward logistic regression models to establish their independent predictors. A statistically significant relationship was found between p-CEA and tumor staging (P , 0.001), T (P , 0.001) and N parameters (P ¼ 0.006). In a multivariate analysis, the independent prognostic factors found were: p-CEA, stages N1 and N2 according to AJCC, and G3 grading (grade). A statistically significant difference (P , 0.001) was evident between the DFS of patients with normal and high p-CEA levels. Preoperative CEA makes a preoperative selection possible of those patients for whom it is likely to be able to predict a more advanced staging.

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Section: Discussionmentioning

confidence: 99%

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Destri

Rubino

Latino

et al. 2015

International Surgery

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“…To reduce the latter, "pathologists' assistants" have been trained to take over some of the pathologists' recurrent tasks. A Dutch study concerning colorectal cancer sampling demonstrated that well-trained pathologist's assistants significantly contribute to patient safety, because their work results in an improved harvest of lymph node (43). Once a lymph node is retrieved, another possible issue is the number of slices to be performed in order not to miss metastases.…”

Section: Factors Related To Pathological Handling: Procedures For Lymmentioning

confidence: 99%

N staging: the role of the pathologist

Marco¹,

Biondi²,

Ricci³

2017

Transl. Gastroenterol. Hepatol.

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Gastric cancer is the second cause of cancer-related mortality worldwide. Metastases, including lymph nodes ones, heavily influence the prognosis of this disease. The pathological detection of positive lymph nodes is pivotal for an optimal prognostication and clinical management of affected individuals.Several factors influence the pathological investigation of surgical specimens, ultimately affecting the number of retrieved lymph nodes and, with it, the reliability of N staging. The pathologist plays a central role in optimizing this process. Factors influencing lymph node retrieval and analysis will be herein reviewed, together with the procedures adopted for an optimal pathological analysis of lymph nodes in gastric cancer.

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“…In the USA, in reports published between 2005 and 2010, despite the "dense forest of articles" [18], the lymphadenectomy was considered inadequate in percentages varying between 63% and 48% of cases [18,19] and similar results were reported in Germany and England [20][21][22].…”

Section: Discussionmentioning

confidence: 71%

Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer

Destri

Privitera

Greca

et al. 2016

International Surgery

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Abstract:Objective The authors seek to assess whether the LNR could predict the risk of metachronous liver metastases. Background data Using the goal of sampling 12 lymph nodes for a proper staging of colorectal cancer is often "uncommon" and the lymph node ratio (LNR) is what allows for a better prognosis selection of patients. Methods A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR. Results The number of lymph nodes sampled in group "stage I" was significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (p <0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P =0.01).Conclusions The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with node-negative cancer (I+II) who developed liver metastases, leads us to believe that some patients have been understaged. We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better sub-stratify "node-positive" patients. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationCover LetterClick here to access/download Cover Letter cover letter.pdf

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Better retrieval of lymph nodes in colorectal resection specimens by pathologists’ assistants

Cited by 31 publications

References 40 publications

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

N staging: the role of the pathologist

Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer

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