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Leibl, S; Tsybrovskyy, O; Denk, H.
How many lymph nodes are necessary to stage early and advanced adenocarcinoma of the sigmoid colon and upper rectum?
Virchows Arch. 2003; 443(2):133-138 Doi: 10.1007/s00428-003-0858-3
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Leading authors Med Uni Graz
Leibl Sebastian
Co-authors Med Uni Graz
Denk Helmut
Tsybrovskyy Oleksiy
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Abstract:
The lymph-node yields in specimens resected for colorectal adenocarcinoma show considerable variations, raising the question whether the minimum lymph-node number recommended by the UICC (International Union Against Cancer) for pN0 classification represents an appropriate quality standard for specimen work-up. The number of pericolic lymph nodes recovered from 568 archival surgical colorectal carcinoma specimens located in the sigmoid or upper rectum showed a highly statistically significant correlation with both the pT category and the presence of metastases ( P<0.0005). The median lymph-node yield in standardized (i.e., resembling in size surgically removed cancer specimens) tumor-free specimens obtained during autopsies was 13 lymph nodes, compared with 20.5 when diverticula were present and more than 30 in specimens with chronic inflammation or from patients with systemic infections. In 48 pT2 and pT3 carcinoma specimens prospectively dissected in the same way, median numbers of 18 (pT2) and 23 (pT3) lymph nodes were detected (range between 8 and 39 nodes). The lymph-node numbers recommended in previous studies and by the UICC often seem to be too low to declare a specimen free of metastases. Although the great variation in lymph-node counts requires the recovery of all lymph nodes for pN0 classification, recommendations considering the pT status and additional factors like diverticula and inflammatory changes can be useful as a quality standard for specimen work up.
Find related publications in this database (using NLM MeSH Indexing)
Adenocarcinoma - classification
Colorectal Neoplasms - classification
Dissection - classification
Humans - classification
Lymph Nodes - pathology
Lymphatic Metastasis - pathology
Medical Oncology - methods
Neoplasm Staging - methods
Prognosis - methods
Specimen Handling - methods

Find related publications in this database (Keywords)
colorectal adenocarcinoma
lymph node yield
TNM classification
quality standards
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