MCACS Home
Annual Meeting Home
Final Program
Past Meetings

Back to Annual Meeting Program


Does Re-Evaluation Of Colorectal Cancers With Inadequate Nodal Yield Lead To Stage Migration Or The Identification Of Metastatic Lymph Nodes?
Lilian Chen1, MD, Matthew Kalady2, MD, FACS, John Goldblum2, MD, Dilara Khoshknabi2, MD, Patricia Roberts1, MD, FACS, Rocco Ricciardi1, MD, MPH, FACS
1Lahey Clinic, Burlington, MA 2Cleveland Clinic, Cleveland, OH

Background: The National Comprehensive Cancer Network recommends routine re-evaluation of all Stage II colorectal cancer specimens with less than 12 lymph nodes. However, there are little data demonstrating the effect of re-evaluation on stage. Methods: We re-reviewed all pathology reports of patients with Stage I through III colorectal cancers with inadequate lymph node yield (less than 12 lymph nodes) that underwent re-evaluation at the request of the surgeon or pathologist from 1/1/2007 through 3/31/2011. We recorded initial pathologic stage and new stage following re-evaluation. We also recorded the following variables before and after re-evaluation: 1) total lymph node count, 2) metastatic node count, 3) negative node count, and 4) lymph node ratio. Results: During the 39 month study period, 87 patients underwent pathologic re-evaluation from a total of 1,682 cancers. Mean nodal yields were 7.22.6 on first pathologic review (0.30.8 metastatic nodes and 6.82.9 negative nodes). On re-evaluation, 83% of patients had one or more newly identified nodes. On average 6.89.4 more lymph nodes were identified on re-evaluation (0.10.4 metastatic nodes and 6.89.4 negative nodes). The re-evaluation revealed a metastatic node in 4 of 87 patients (4.6%). After pathologic re-evaluation, one patient (1.1%) had a change in TNM stage from N1 to N2 disease. Conclusion: Our comprehensive review of colorectal cancer specimens reveals that few patients have a newly discovered metastatic node or stage change following re-evaluation. These data demonstrate minimal benefit to routine re-evaluation of colorectal cancers with less than 12 lymph nodes.


Back to Annual Meeting Program

 



© 2023 Massachusetts Chapter of the American College of Surgeons. All Rights Reserved. Privacy Policy.