Clinicopathologic factors associated with lymph node retrieval in resectable colon cancer: a Veterans' Affairs Central Cancer Registry (VACCR) database analysis.

BACKGROUND: A long-term determinant of survival in resectable colon cancer is the involvement of regional lymph nodes. We evaluated the clinicopathologic factors associated with lymph node retrieval. METHODS: We conducted a retrospective analysis of patients with resected stage I-III colon cancer in the Veteran's Affairs Central Cancer Registry between 1995 and 2008. One-way ANOVA compared the differences between various groups. Multivariate logistic regression analysis was performed to determine the factors associated with the harvest of 12 or more lymph nodes for pathologic examination. RESULTS: There were 19,240 patients with resectable colon cancer included in our analysis. Mean number of lymph nodes retrieved increased with later year of diagnosis, higher overall stage, higher T descriptor, age <65 years, poorer differentiation and right-sided tumors (P < 0.01 for all covariates). These aforementioned factors are also associated with an increased probability of retrieving 12 or more lymph nodes after surgical resection (P < 0.01 for all covariates). CONCLUSIONS: Later year of diagnosis, younger patients, right-sided tumors, poorer differentiation, higher T descriptor and overall stage are associated with increased number of lymph nodes retrieved. These may indicate the presence of an immunological response of tumor versus host affecting lymph node retrieval.

Needle-core biopsy in the pathologic diagnosis of malignant lymphoma showing high reproducibility among pathologists.

OBJECTIVES: To evaluate the role of needle-core biopsy in the pathologic diagnosis of lymphoma. METHODS: One hundred and five cases with clinical suspicion for lymphoma were studied by 3 hematopathologists mimicking daily diagnostic service. The diagnostic result sheets were analyzed for diagnostic accuracy and reproducibility. The histologic pattern recognition by the 3 hematopathologists was also analyzed. RESULTS: The overall diagnostic accuracy, based on the consensus diagnosis, was 85% to 87%. High reproducibility of diagnosis in lymphoma was observed among pathologists. The tissue size was associated with the percentage of definitive diagnosis. Histologic patterns were well recognized on core tissues. CONCLUSIONS: Needle-core biopsy is an effective technique for the diagnosis of lymphoma and should be considered the first-line procedure for cases with suspicion for lymphoma.