Colorectal surgical specimen lymph node harvest: improvement of lymph node yield with a pathology assistant.
BACKGROUND
Adequate lymph node harvest from colorectal cancer specimens has become a standard of care, influencing both staging and survival. To improve lymph node harvests at our hospital, a pathology assistant was trained to meticulously harvest lymph nodes from colorectal cancer specimens. An analysis of trends in lymph node harvests over time is presented.


METHODS
The number of harvested lymph nodes from 391 consecutive colorectal cancer pathology reports was retrospectively reviewed from a single community hospital over 8 years (1999-2006). This spanned 4 years prior to the training of the pathology assistant and 4 years after.


RESULTS
From 1999-2002, the mean number of harvested lymph nodes varied from 12.2 to 14.4. The percentage of specimens achieving 12 lymph nodes was 50-67%. From 2003-2006, the mean number of harvested lymph nodes increased to 18.4-20.7, while the percentage of specimens achieving 12 lymph nodes was 83-87%. Both of these improvements achieved statistical significance with p values of <0.00001.


CONCLUSIONS
Over time, lymph node harvests at our hospital dramatically improved. The training of a pathology assistant to harvest the lymph nodes from colorectal cancer specimens dramatically affected lymph node harvests and can be a crucial component of pathologic analysis of these specimens.
Reese
Jeffery A
JA
Department of Radiology, McKay-Dee Hospital Center, 4403 Harrison Boulevard, Ogden, UT 84403, USA.
Hall
Christopher
C
Bowles
Kelly
K
Moesinger
Robert C
RC
D000005:Abdomen; D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary*; D002983:Clinical Competence / Q000592:standards*; D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D010340:Pathology, Surgical; D010823:Physician Assistants / Q000639:trends*; D012189:Retrospective Studies; D013048:Specimen Handling / Q000379:methods*; D000078329:Workforce