Colorectal surgical specimen lymph node harvest: improvement of lymph node yield with a pathology assistant

J Gastrointest Surg. 2009 Aug;13(8):1459-63. doi: 10.1007/s11605-009-0820-z. Epub 2009 May 21.

Abstract

Introduction: Adequate lymph node harvest from colorectal cancer specimens has become a standard of care, influencing both staging and survival. To improve lymph node harvests at our hospital, a pathology assistant was trained to meticulously harvest lymph nodes from colorectal cancer specimens. An analysis of trends in lymph node harvests over time is presented.

Methods: The number of harvested lymph nodes from 391 consecutive colorectal cancer pathology reports was retrospectively reviewed from a single community hospital over 8 years (1999-2006). This spanned 4 years prior to the training of the pathology assistant and 4 years after.

Results: From 1999-2002, the mean number of harvested lymph nodes varied from 12.2 to 14.4. The percentage of specimens achieving 12 lymph nodes was 50-67%. From 2003-2006, the mean number of harvested lymph nodes increased to 18.4-20.7, while the percentage of specimens achieving 12 lymph nodes was 83-87%. Both of these improvements achieved statistical significance with p values of <0.00001.

Conclusions: Over time, lymph node harvests at our hospital dramatically improved. The training of a pathology assistant to harvest the lymph nodes from colorectal cancer specimens dramatically affected lymph node harvests and can be a crucial component of pathologic analysis of these specimens.

Publication types

  • Comparative Study

MeSH terms

  • Abdomen
  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary*
  • Clinical Competence / standards*
  • Colorectal Neoplasms / pathology*
  • Humans
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Pathology, Surgical*
  • Physician Assistants / trends*
  • Retrospective Studies
  • Specimen Handling / methods*
  • Workforce