Despite some improvement since 1988, the majority of patients with colorectal cancer in 2001 received inadequate lymph node evaluation to see if their cancer had spread, according to a new study.
Lymph node status is the strongest predictor of outcome for colorectal cancer patients. Only 40% of patients with lymph node metastases will survive for 5 years after diagnosis compared with 68% of patients with no metastases. Detection of lymph node metastases, therefore, is important for predicting patient outcomes and ensuring that patients receive necessary treatment. Current guidelines recommend that a minimum of 12 lymph nodes be examined to ensure adequate sampling.
To determine if colorectal cancer patients receive adequate lymph node evaluation, Nancy N. Baxter, M.D., Ph.D., of the University of Minnesota in Minneapolis, and colleagues examined data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. They looked at lymph node evaluations from nearly 117,000 adults who had been diagnosed with colorectal cancer between 1988 and 2001. Only 37% of patients had received adequate lymph node evaluation--i.e., 12 or more lymph nodes examined. However, the proportion of patients who received adequate lymph node evaluation increased over time, from 32% in 1988 to 44% in 2001.
"Further research should evaluate factors associated with increased lymph node retrieval and should assess intervention strategies to ensure proper surgical care and pathologic assessment," the authors write.
Contact: Mary Lawson, University of Minnesota Cancer Center, 612-624-6165, firstname.lastname@example.org
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Journal of the National Cancer Institute