Colorectal cancer is the third most common type of cancer and also the third leading cause of cancer death in the United States. Some patients will have localized colorectal cancers, while others will have a tumor that spreads.Removal and analysis of lymph nodes during surgery for colorectal cancer is accepted as a good approach to detecting whether cancer has spread and whether it is likely to recur. The debate, however, has been over how many lymph nodes ought to be removed during such operations. In 1990, the World Congress of Gastroenterology came out in favor of removing at least 12 lymph nodes to ensure the best outcome for the patient with colorectal cancer.
In a new study, researchers at Rush Medical Center and Skokie Hospital, Illinois, report on a multidisciplinary initiative aimed at improving and standardizing their approach to colorectal cancer surgery. They examined the cases of 701 colorectal cancer patients treated between 1996 and 2007. The findings revealed two things. First, this initiative was indeed able to increase the number of lymph nodes removed during colorectal cancer surgery – from 12.8 on average before it started to 17.3 afterwards. And the percentage of colorectal cancer patients having at least 12 lymph nodes removed went up from 53% to 71.6% - showing that adherence to clinical guidelines can be improved a lot. However, the study also showed that the number of patients shown to have advanced colorectal cancer did not change with the number of lymph nodes removed increased. Therefore, it may be time for another look at the guidelines on lymph node examination and colorectal cancer prognosis.
Source
Kukreja S, Esteban-Agusti E et al Evaluating more lymph nodes may not improve identification of late-stage colorectal cancer Archives of Surgery July 2009;144:612-617
Created on: 08/05/2009
Reviewed on: 08/05/2009
Reviewed on: 08/05/2009
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