title: Factors affecting lymph node yield from patients undergoing colectomy for cancer.
abstract: OBJECTIVE
  Lymph node (LN) yield is a critical component of colon cancer staging and is often a surrogate for quality assessment in surgery. We investigated the impact of pathologists' training on LN harvest.
  
  
  METHODS
  This is a retrospective review on 137 patients undergoing elective colectomy for adenocarcinoma at a single institution from 2008 to 2009. We studied surgeon-, patient- and pathologist-derived factors, and identified independent variables affecting LN yield using logistic regression.
  
  
  RESULTS
  LN yield was similar between open and laparoscopic resections (21 versus 23, p = 0.54). Similarly, nodal counts were independent of tumor location (p = 0.08) and no difference was noted between colorectal and general surgeons (24 versus 21, p = 0.31). Strikingly, the number of LNs reported by PGY-1 pathology residents was significantly higher than those with two or more years of training (24 versus 19, p = 0.02). On logistic regression, only the reporting pathologists' year in training remained a significant predictor of the number of nodes reported (OR = 5.28, p = 0.0001).
  
  
  CONCLUSIONS
  LN retrieval in patients with colon cancer is inversely related to the interpreting pathologists' level of training.
authors.affiliation: Division of Gastrointestinal Surgery, Colon and Rectal Surgery Program, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Zubin M
authors.initials: ZM
authors.lastname: Bamboat
authors.forename: Danielle
authors.initials: D
authors.lastname: Deperalta
authors.forename: Abdulmetin
authors.initials: A
authors.lastname: Dursun
authors.forename: David L
authors.initials: DL
authors.lastname: Berger
authors.forename: Liliana
authors.initials: L
authors.lastname: Bordeianou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged