title: Alcohol fat clearing increases lymph node yield after surgery for colorectal cancer.
abstract: Lymph node (LN) yield is associated with oncologic outcome in patients who undergo surgery for colorectal adenocarcinoma (CRC). Standards to maximize LN yield have been initiated to enhance treatment of patients with CRC. This study evaluates the impact of a simple alcohol-based preparation protocol on LN yield. Surgical specimens from patients with CRC were prepared using either the alcohol protocol or standard formalin fixation and LN yield was compared. In total, 80 consecutive patients (n = 40 formalin, n = 40 alcohol) were examined. Overall, median LN yield increased from 17 to 29 (P < 0.01) with the alcohol fat clearance protocol. For patients with rectal adenocarcinoma who underwent proctectomy after neoadjuvant chemoradiotherapy, LN yield increased from 15 to 23 (P = 0.02). The frequency of need for additional sampling to achieve a minimum 12 LN count was also reduced. Initiation of a standardized alcohol fat-clearing protocol increased LN yield after surgery for CRC. This simple, cost-effective measure may improve the efficiency of LN assessment and accurate staging, which may impact oncologic outcomes.
authors.affiliation: Department of Surgery, Loma Linda University School of Medicine, Loma Linda, California, USA.
authors.forename: Marjun
authors.initials: M
authors.lastname: Duldulao
authors.forename: Cassie
authors.initials: C
authors.lastname: Booth
authors.forename: Laura
authors.initials: L
authors.lastname: Denham
authors.forename: Audrey
authors.initials: A
authors.lastname: Choi
authors.forename: Garrett
authors.initials: G
authors.lastname: Friedman
authors.forename: Kevork
authors.initials: K
authors.lastname: Kazanjian
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D000431:Ethanol; D005260:Female; D005557:Formaldehyde; D016591:Histocytological Preparation Techniques / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012007:Rectum / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012997:Solvents
chemical_list: D012997:Solvents; D005557:Formaldehyde; D000431:Ethanol