Abstract
Background: Consensus guidelines recommend a yield of 12 lymph nodes in resections for colon cancer. Factors affecting this yield are not well defined. Methods: Retrospective study using the colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program for years 2014–2016. Primary outcome was resection of at least 12 nodes. Univariate and multivariate analyses determined factors associated with ≥12 LN yield. Results: 17,612 colectomies for colon cancer were extracted from the NSQIP database. 7.26% of cases did not reach a 12 LN harvest. Harvesting ≥12 LN was 74% more likely (p = 0.001) if the resection was laparoscopic and 72% more likely (p < 0.0001) if hand-assisted. Advanced T and N stage had a higher likelihood of reaching 12 LN harvest. Older age, female gender and smoking history decreased the likelihood of ≥12 LN harvest. Conclusions: Laparoscopic and robotic colectomies were 1.5–2.5 times more likely to achieve adequate LN harvest compared to open surgery. Several non-modifiable patient and disease related factors may render adequate LN yield challenging.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 113-118 |
| Number of pages | 6 |
| Journal | American journal of surgery |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 2019 |
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Keywords
- Colectomy
- Colon cancer
- Lymph node harvest
- Outcomes
- Surgical quality
ASJC Scopus subject areas
- Surgery
Cite this
Predictors of adequate lymph node harvest during colectomy for colon cancer. / Douaiher, Jeffrey; Hussain, Tanvir; Langenfeld, Sean J.
In: American journal of surgery, Vol. 218, No. 1, 07.2019, p. 113-118.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of adequate lymph node harvest during colectomy for colon cancer
AU - Douaiher, Jeffrey
AU - Hussain, Tanvir
AU - Langenfeld, Sean J.
PY - 2019/7
Y1 - 2019/7
N2 - Background: Consensus guidelines recommend a yield of 12 lymph nodes in resections for colon cancer. Factors affecting this yield are not well defined. Methods: Retrospective study using the colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program for years 2014–2016. Primary outcome was resection of at least 12 nodes. Univariate and multivariate analyses determined factors associated with ≥12 LN yield. Results: 17,612 colectomies for colon cancer were extracted from the NSQIP database. 7.26% of cases did not reach a 12 LN harvest. Harvesting ≥12 LN was 74% more likely (p = 0.001) if the resection was laparoscopic and 72% more likely (p < 0.0001) if hand-assisted. Advanced T and N stage had a higher likelihood of reaching 12 LN harvest. Older age, female gender and smoking history decreased the likelihood of ≥12 LN harvest. Conclusions: Laparoscopic and robotic colectomies were 1.5–2.5 times more likely to achieve adequate LN harvest compared to open surgery. Several non-modifiable patient and disease related factors may render adequate LN yield challenging.
AB - Background: Consensus guidelines recommend a yield of 12 lymph nodes in resections for colon cancer. Factors affecting this yield are not well defined. Methods: Retrospective study using the colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program for years 2014–2016. Primary outcome was resection of at least 12 nodes. Univariate and multivariate analyses determined factors associated with ≥12 LN yield. Results: 17,612 colectomies for colon cancer were extracted from the NSQIP database. 7.26% of cases did not reach a 12 LN harvest. Harvesting ≥12 LN was 74% more likely (p = 0.001) if the resection was laparoscopic and 72% more likely (p < 0.0001) if hand-assisted. Advanced T and N stage had a higher likelihood of reaching 12 LN harvest. Older age, female gender and smoking history decreased the likelihood of ≥12 LN harvest. Conclusions: Laparoscopic and robotic colectomies were 1.5–2.5 times more likely to achieve adequate LN harvest compared to open surgery. Several non-modifiable patient and disease related factors may render adequate LN yield challenging.
KW - Colectomy
KW - Colon cancer
KW - Lymph node harvest
KW - Outcomes
KW - Surgical quality
UR - http://www.scopus.com/inward/record.url?scp=85067235678&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067235678&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2018.08.020
DO - 10.1016/j.amjsurg.2018.08.020
M3 - Article
C2 - 30201139
AN - SCOPUS:85067235678
VL - 218
SP - 113
EP - 118
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 1
ER -