caa a22 4500 44533830X CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1269-8 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1269-8 Variation in Lymph Node Evaluation in Rectal Cancer: A Dutch Nationwide Population-Based Study [Elektronische Daten] [M. Elferink, S. Siesling, V. Lemmens, O. Visser, H. Rutten, J. van Krieken, R. Tollenaar, J. Langendijk] Background: For adequate staging and subsequent accurate estimation of prognosis, a sufficient number of lymph nodes (LNs) has to be evaluated. This study aimed to identify factors associated with adequate nodal evaluation and to determine its relationship with survival. Methods: Data from all patients with stage I to III rectal carcinoma who underwent surgical treatment and who were diagnosed in the period 2000 to 2006 were retrieved from the Netherlands Cancer Registry. Multilevel logistic analysis was performed to examine the influence of relevant factors on the number of evaluated LNs. Kaplan-Meier and Cox regression analyses were used to analyze the association with overall survival. Results: The number of evaluated LNs was determined for 10,788 (91%) of 11,818 tumors. Median number of evaluated LNs was 7, ranging from 4 to 11 between pathology laboratories. The proportion of patients with positive LNs increased with increasing number of evaluated LNs. Men, younger patients, tumors with deeper invasion and nodal involvement, patients without preoperative radiotherapy who underwent a low anterior resection, and patients whose LNs were evaluated in an academic pathology laboratory were more likely to have ≥12 LNs evaluated. After adding these factors to the model, unexplained variation between pathology laboratories and between hospitals remained. The overall survival increased with increasing number of evaluated LNs. Conclusions: A large variation in LN evaluation among patients with rectal cancer was revealed. Improvement in LN evaluation by both hospitals and pathology laboratories could improve staging, leading to more reliable estimation of prognosis. Society of Surgical Oncology, 2010 Elferink M. Department of Research, Comprehensive Cancer Center North East, Groningen, The Netherlands aut Siesling S. Department of Research, Comprehensive Cancer Center North East, Groningen, The Netherlands aut Lemmens V. Department of Research, Comprehensive Cancer Center South, Eindhoven, The Netherlands aut Visser O. Comprehensive Cancer Center Amsterdam, Amsterdam, The Netherlands aut Rutten H. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands aut van Krieken J. Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut Tollenaar R. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut Langendijk J. Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 386-395 1068-9265 18:2<386 2011 18 10434 https://doi.org/10.1245/s10434-010-1269-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1269-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Elferink M. Department of Research, Comprehensive Cancer Center North East, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Siesling S. Department of Research, Comprehensive Cancer Center North East, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Lemmens V. Department of Research, Comprehensive Cancer Center South, Eindhoven, The Netherlands aut NATIONALLICENCE 700 1- Visser O. Comprehensive Cancer Center Amsterdam, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Rutten H. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands aut NATIONALLICENCE 700 1- van Krieken J. Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Tollenaar R. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Langendijk J. Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 386-395 1068-9265 18:2<386 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer