Introduction: The study aims to analyze the correlation between lymph node harvest (LNH) and node involvement (LNI) in resected primary colorectal cancer specimens.
Patients & methods: Retrospective analysis. The study period is Jan 2002 – Dec 2006 (5y). The data were obtained from medical records. The patient inclusion criteria were resection of primary CRC including synchronous or metachronous cancer. Exclusion criteria were recurrent CRC, cancer not operated, cancer not resected and endomucosal resection. LNH and LNI were obtained. The data were analyzed and compared with literature and national audit.
Results: There were 142 resections (mean =28 per annum). M:F ratio=0.97:1. Median age=71y. There were 86 (60.5%) colonic and 56 (39.5%) rectal cancers. There were 70 (49.3%) anterior resections and 11 APRs from a total of 83 rectal resections (pan-proctocolectomy=2). Median CRM=7.5mm. The CRM involvement=12.7% for all CRC and 16% for rectal cancers. Median overall LNH was 12 (mean=13 p=0.08 when compared to the recommended LNH=12). Median LNH for rectal cancers=11 and for colonic cancer=13. R0 resections=84%. 30-day mortality=4.3%. There was 17.6% chance of metastasis at presentation. All-stage 3-year disease-free survival (DFS) was 67% and 82% for stages I-III (Tany Nany M0).
When correlation was determined between LNH and lymph node involvement, it revealed a low correlation (r=0.16 p=0.06). When the national audit calculated the same relationship among its much larger sample the results were the same (r=0.15 p=0.001).
Conclusion: LNI as a function of tumour and host behaviour is of prognostic significance. LNH is dependent on multiple factors and may be a quality assurance (QA) tool to be used to compare inter-institutional standard of multi-disciplinary meetings (MDM)
Program Number: P111