title: Volume of surgical activity and lymph node evaluation for patients with colorectal cancer in France.
abstract: BACKGROUND
  The correct examination of lymph nodes is decisive for tumour classification into stage 2 and stage 3. The aim of this specialised population-based study was to investigate the influence of clinical factors and volume of surgical activity on lymph node assessment in France for patients diagnosed with localised colorectal cancer.
  
  
  METHODS
  From 1997 to 2004, French digestive cancer registries recorded a total of 4197 cases of colorectal cancer. The volume of surgical activity was appreciated by the annual number of digestive surgery admissions in 2004. The probability of having at least 12 lymph nodes examined after surgical resection was analysed using a multilevel logistic regression model.
  
  
  RESULTS
  Only 1900 patients had more than 12 lymph nodes examined (45.2%). The percentage of patients with at least 12 lymph nodes examined after tumour resection is directly associated with the volume of surgical activity within care centres for patients diagnosed between 1997 and 2000. This association was no longer significant during the second period study (2001-2004).
  
  
  CONCLUSIONS
  This population-based study reports that only 55% of colorectal patients have a sufficient number of lymph nodes examined. This insufficient number of examined lymph nodes could be considered as a potential prospect for increasing treatment quality in cancer patients in France.
authors: "Cancers & Populations" ERI3 INSERM, EA 3936 UCBN University of Caen, CHU de Caen, France. olivier.dejardin@unicaen.fr
authors: Olivier
authors: O
authors: Dejardin
authors: Edouard
authors: E
authors: Ruault
authors: Valérie
authors: V
authors: Jooste
authors: Carole
authors: C
authors: Pornet
authors: Véronique
authors: V
authors: Bouvier
authors: Anne-Marie
authors: AM
authors: Bouvier
authors: Guy
authors: G
authors: Launoy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision / Q000592:standards* / Q000706:statistics & numerical data*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D019984:Quality Indicators, Health Care; D012042:Registries; D012111:Residence Characteristics