[Resection time and number of detected colorectal lymph nodes in resection specimens with carcinoma].
BACKGROUND
The number of identified lymph nodes (LNs) is an essential element in the pathologist's rapport on colorectal resection specimens with carcinoma (CRSC). A considerable number of papers discuss the acceptable minimum number of identified LNs to secure a correct LN status (LNS). Details as to the most appropriate grossing technique for LN detection are, however, largely lacking. In this paper the influence of the time invested by the pathologist in the pursuit of LN is investigated.


METHODS
The material comprised 150 CRSCs. The usual gross examination was extended by 15 minutes in an effort to identify additional LNs. Provided this careful analysis failed to produce 12 LNs and all detected LNs were benign (pNx), the specimen was re-sampled for an additional 15-minute period. Data were correlated with a baseline material comprising 100 CRSCs.


RESULTS
The intensified search for LNs increased the average number of LNs pr. specimen from 9.1 to 14.9. The number of cases with pNx was reduced from 54% to 18%. Re-sampling performed on 25 specimens resulted in the detection of another 61 LNs in 21 cases, ranging from 1 to 8 LN pr. specimen (median 2), whereby pNx was converted to pN0 in eight cases. In another four cases, additional LNs were not detected. Re-sampling did not uncover metastatic disease.


CONCLUSIONS
This intensified effort in the Department of Pathology resulted in a more reliable LNS.
Schmidt
Mads Bo
MB
Patologiafdelingen, Hvidovre Hospital, DK-2650 Hvidovre.
Engel
Ulla Højholt
UH
Mogensen
Anne Mellon
AM
Petersen
Lone Nørgård
LN
Bülow
Steffen
S
Wied
Uhle
U
Holck
Susanne
S
D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging; D011446:Prospective Studies; D013048:Specimen Handling; D013997:Time Factors