caa a22 4500 445338180 CHVBK 20180317142802.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1308-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1308-5 Individual Surgeon, Pathologist, and Other Factors Affecting Lymph Node Harvest in Stage II Colon Carcinoma. Is a Minimum of 12 Examined Lymph Nodes Sufficient? [Elektronische Daten] [Luca Stocchi, Victor Fazio, Ian Lavery, Jeff Hammel] Background: Insufficient lymph node harvest in presumed stage II colon carcinomas can result in understaging and worsened cancer outcomes. The purpose of this study was to evaluate factors affecting the number of lymph node examined, their corresponding impact on cancer outcomes, and the optimal number of examined nodes with reference to the standard of 12. Materials and Methods: We evaluated all patients undergoing surgery alone for stage II colon cancer included in our colorectal cancer database since 1976. Results: A total of 901 patients were included. Mean follow-up exceeded 8years. The individual pathologist had no statistically significant association with the number of lymph nodes examined. Harvest of at least 12 nodes was related to surgery after 1991 (85% vs 69%, P<0.001), right vs left colon carcinomas (85% vs 72%, P<0.001), individual surgeon (P=0.018), and length of specimen at different cutoffs of at least 30, 25, and 20cm (P<0.001). Increasing age was associated with fewer examined lymph nodes (Spearman correlation=−0.22, P<0.001). Fewer than 12 nodes and T4N0 staging independently affected overall survival (P=0.003 and P=0.022, respectively), disease-free survival (P=0.010 and P=0.09, respectively), disease-specific mortality (P=0.009 and P<0.001, respectively), and overall recurrence (P=0.13 and P=0.023, respectively). A minimal number of more than 12 examined nodes had no significant effect on cancer outcomes. Conclusions: A number of factors influenced lymph node harvest in stage II colon cancer. However, lymph node assessment of at least 12 nodes was the only modifiable factor optimizing cancer outcomes. Society of Surgical Oncology, 2010 Stocchi Luca Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut Fazio Victor Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut Lavery Ian Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut Hammel Jeff Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 405-412 1068-9265 18:2<405 2011 18 10434 https://doi.org/10.1245/s10434-010-1308-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1308-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stocchi Luca Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Fazio Victor Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Lavery Ian Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Hammel Jeff Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 405-412 1068-9265 18:2<405 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer