Clinical and pathologic factors affecting lymph node yields in colorectal cancer

Lymph node yield is recommended as a benchmark of quality care in colorectal cancer. The objective of this study was to evaluate the impact of various factors upon lymph node yield and to identify independent factors associated with lymph node harvest. The records of 162 patients with Stage I to Sta...

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Bibliographic Details
Published in:PloS one 2013-07, Vol.8 (7), p.e68526-e68526
Main Authors: Hsu, Ta-Wen, Lu, Hsin-Ju, Wei, Chang-Kuo, Yin, Wen-Yao, Chang, Chun-Ming, Chiou, Wen-Yen, Lee, Moon-Sing, Lin, Hon-Yi, Su, Yu-Chieh, Hung, Shih-Kai
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biopsy
Buddhism
Cancer
Cancer therapies
Care and treatment
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - surgery
Data processing
Demographics
Female
Hospitals
Humans
Identification methods
Linear Models
Lymph nodes
Lymph Nodes - surgery
Lymphatic system
Male
Mathematics
Medical care quality
Medical personnel
Medical prognosis
Medicine
Middle Aged
Oncology
Patients
Performance prediction
Physicians
Quality
Regression analysis
Regression models
Review boards
Risk groups
Surgeons
Surgery
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Summary:Lymph node yield is recommended as a benchmark of quality care in colorectal cancer. The objective of this study was to evaluate the impact of various factors upon lymph node yield and to identify independent factors associated with lymph node harvest. The records of 162 patients with Stage I to Stage III colorectal cancers seen in one institution were reviewed. These patients underwent radical surgery as definitive therapy; high-risk patients then received adjuvant treatment. Pathologic and demographic data were recorded and analyzed. The subgroup analysis of lymph node yields was determined using a t-test and analysis of variants. Linear regression model and multivariable analysis were used to perform potential confounding and predicting variables. Five variables had significant association with lymph node yield after adjustment for other factors in a multiple linear regression model. These variables were: tumor size, surgical method, specimen length, and individual surgeon and pathologist. The model with these five significant variables interpreted 44.4% of the variation. Patients, tumor characteristics and surgical variables all influence the number of lymph nodes retrieved. Physicians are the main gatekeepers. Adequate training and optimized guidelines could greatly improve the quality of lymph node yields.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0068526