Open AccessClinical and Pathologic Factors Affecting Lymph Node Yields in Colorectal Cancer
Author(s) -
Ta-Wen Hsu,
Hsin-Ju Lu,
ChangKuo Wei,
Weiqiang Yin,
ChunMing Chang,
WenYen Chiou,
MoonSing Lee,
HonYi Lin,
YuChieh Su,
ShihKai Hung
Publication year - 2013
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0068526
Subject(s) - lymph node , medicine , colorectal cancer , confounding , lymph , proportional hazards model , adjuvant therapy , stage (stratigraphy) , linear regression , regression analysis , cancer , oncology , surgery , pathology , statistics , mathematics , biology , paleontology
Objective 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. Materials and Methods 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. Results 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. Conclusions 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.