Factors affecting number of lymph nodes harvested in colorectal cancer.
BACKGROUND
Lymph node involvement is a highly important prognostic factor in colorectal cancer staging. Examination of a minimum of 12 nodes is recommended for accurate staging. The purpose of this study was to identify factors affecting the number of lymph nodes harvested in colorectal cancer specimens.


METHODS
Retrospective review of all patients undergoing colectomy for colorectal cancer at our VA hospital from 2002 to 2007 was done. Statistical analysis was done using univariate as well as multivariate analysis. One hundred eighty-three patients were analyzed.


RESULTS
Average number of nodes retrieved was 14.9 with 92 (51%) containing fewer than 12 lymph nodes. Median number of nodes was 11. The only two factors found to have an effect on nodes harvested were pathologist P<0.05 and surgeon experience P=0.01. Factors not found to have an impact on number of nodes harvested were age of patient, previous operation, T stage of tumor, type of colectomy, bowel prep, laparoscopic versus open technique, or BMI. Multivariate analysis confirmed pathologist and surgeon experience as independent factors associated with number of nodes retrieved P<0.05.


CONCLUSIONS
Operating surgeon and examining pathologist were the only factors found to have a significant impact on number of nodes harvested. Meticulous dissection both in and outside of the operating room are indicated.
Leung
Anna Mary
AM
Department of Surgery at the Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, Virginia 23298-0568, USA. amleung@vcu.edu
Scharf
Andrew W
AW
Vu
Huan Nguyen
HN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000592:standards*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012189:Retrospective Studies