Does specialized surgical training increase lymph node yield in colon cancer?
Am Surg
; 75(10): 887-91, 2009 Oct.
Article
en En
| MEDLINE
| ID: mdl-19886128
ABSTRACT
Most colon cancer resections do not meet the 12-lymph node minimum recommended in 2001 National Cancer Institute (NCI) panel guidelines. Previous reports suggest surgical training influences lymph node recovery. We hypothesized that recent trends show improved results for lymphadenectomy regardless of specialty. The cancer registry database at a large community hospital with an academic surgical oncology training program was queried to identify resections performed for colon cancer before (1995 to 2000) and after (2001 to 2006) NCI guideline publication. There were no changes in pathology procedures between 374 early and 411 later procedures. The later period brought increases in mean total lymph nodes (15.4 vs 10.4, P < 0.0001), total positive nodes (1.8 vs 1.2, P = 0.005), and the percentage of procedures yielding 12 or more nodes (overall 65.9 vs 36.0%, P < 0.0001; Stage II and III disease 73.0 vs 41.4%, P < 0.003). In addition, mean nodal yield increased (P < 0.0001) for fellowship-trained surgeons (16.7 vs 11.2) and nonfellowship-trained surgeons (14.9 vs 10.2). Single-registry data show that since 2001, most colon resections exceed minimum recommendations for lymph node recovery regardless of surgical training. The increased rate of adequate lymphadenectomy for Stage II and III disease is encouraging because this patient population will benefit most by accurate staging of colon cancer.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cirugía General
/
Cirugía Colorrectal
/
Neoplasias del Colon
/
Becas
/
Escisión del Ganglio Linfático
/
Oncología Médica
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Am Surg
Año:
2009
Tipo del documento:
Article
País de afiliación:
Estados Unidos