Wednesday, July 22, 2009
WEDNESDAY, July 22 (HealthDay News) -- Retrieving a high number of lymph nodes in colorectal cancer patients does not help to identify more patients with stage III cases of the disease, a finding which undermines the case for retrieval of at least 12 lymph nodes as a benchmark quality measure of surgical treatment, according to a study in the July issue of the Archives of Surgery.
Sachin S. Kukreja, M.D., of Rush University Medical Center in Chicago, and colleagues conducted a study of 701 colorectal cancer patients, of whom 553 underwent surgical resection before the implementation of an initiative to emphasize the importance of lymph node counts, while 148 underwent surgery after the initiative was implemented.
Lymph node counts increased from a mean 12.8 before the initiative was introduced to 17.3 afterward, and 71.6 percent of the latter group of patients had at least 12 nodes examined compared to 53 percent of the pre-intervention period patients, the investigators found. While 204 (36.9 percent) of the pre-intervention patients were diagnosed with stage III cancer, 48 (32.4 percent) of the post-intervention group had this diagnosis, but among the patients with positive lymph nodes the distribution of N1 and N2 disease was the same in both groups, the researchers discovered.
"Our data suggest that harvest of at least 12 lymph nodes as a quality or performance measure appears unfounded," the authors conclude.
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