Abstract
The aim of the paper was to establish if the 12 lymph nodes recommended by tumor-node-metastasis (TNM) system are sufficient for a correct staging of rectal cancer. For this purpose, we first compared the mean number of lymph nodes recovered in the same surgical specimen at the routine sampling and at a resampling performed by a second expert gastrointestinal pathologist. The study was performed on 50 cases of pT2N0 and pT3N0 rectal cancers, with a minimum number of 12 lymph nodes recovered at first sampling, histologically negative for metastases. Resampling retrieved a variable number (1 to 24) of nodes missed at first sampling. The final pN0 status was maintained in pT2 patients, whereas in 18.7% of pT3 patients, metastatic lymph nodes were detected if the mean number of lymph nodes increased from 17.8 to 26.8 after the second sampling. Interestingly, all pN1 patients had only a single metastatic lymph node measuring less than 4.9 mm. As we have shown that most (five out of six) missed metastatic lymph nodes were detected in specimens in which a maximum number of 19 lymph nodes had been originally recovered, we strongly suggest a resampling of pT3N0 rectal specimens if less than 20 lymph nodes have been recovered.
| Original language | English |
|---|---|
| Pages (from-to) | 647-651 |
| Number of pages | 5 |
| Journal | Virchows Archiv |
| Volume | 449 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2006 |
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Keywords
- Lymph node yield
- Perirectal tissue sampling
- Quality standard
- Rectal cancer
ASJC Scopus subject areas
- Pathology and Forensic Medicine
Cite this
Potential pathological understaging of pT3 rectal cancer with less than 26 lymph nodes recovered : A prospective study based on a resampling of 50 rectal specimens. / Greco, Paolo; Andreola, Salvatore; Magro, Gaetano; Belli, Filiberto; Giannone, Giorgio; Gallino, Gian Francesco; Leo, Ermanno.
In: Virchows Archiv, Vol. 449, No. 6, 12.2006, p. 647-651.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Potential pathological understaging of pT3 rectal cancer with less than 26 lymph nodes recovered
T2 - A prospective study based on a resampling of 50 rectal specimens
AU - Greco, Paolo
AU - Andreola, Salvatore
AU - Magro, Gaetano
AU - Belli, Filiberto
AU - Giannone, Giorgio
AU - Gallino, Gian Francesco
AU - Leo, Ermanno
PY - 2006/12
Y1 - 2006/12
N2 - The aim of the paper was to establish if the 12 lymph nodes recommended by tumor-node-metastasis (TNM) system are sufficient for a correct staging of rectal cancer. For this purpose, we first compared the mean number of lymph nodes recovered in the same surgical specimen at the routine sampling and at a resampling performed by a second expert gastrointestinal pathologist. The study was performed on 50 cases of pT2N0 and pT3N0 rectal cancers, with a minimum number of 12 lymph nodes recovered at first sampling, histologically negative for metastases. Resampling retrieved a variable number (1 to 24) of nodes missed at first sampling. The final pN0 status was maintained in pT2 patients, whereas in 18.7% of pT3 patients, metastatic lymph nodes were detected if the mean number of lymph nodes increased from 17.8 to 26.8 after the second sampling. Interestingly, all pN1 patients had only a single metastatic lymph node measuring less than 4.9 mm. As we have shown that most (five out of six) missed metastatic lymph nodes were detected in specimens in which a maximum number of 19 lymph nodes had been originally recovered, we strongly suggest a resampling of pT3N0 rectal specimens if less than 20 lymph nodes have been recovered.
AB - The aim of the paper was to establish if the 12 lymph nodes recommended by tumor-node-metastasis (TNM) system are sufficient for a correct staging of rectal cancer. For this purpose, we first compared the mean number of lymph nodes recovered in the same surgical specimen at the routine sampling and at a resampling performed by a second expert gastrointestinal pathologist. The study was performed on 50 cases of pT2N0 and pT3N0 rectal cancers, with a minimum number of 12 lymph nodes recovered at first sampling, histologically negative for metastases. Resampling retrieved a variable number (1 to 24) of nodes missed at first sampling. The final pN0 status was maintained in pT2 patients, whereas in 18.7% of pT3 patients, metastatic lymph nodes were detected if the mean number of lymph nodes increased from 17.8 to 26.8 after the second sampling. Interestingly, all pN1 patients had only a single metastatic lymph node measuring less than 4.9 mm. As we have shown that most (five out of six) missed metastatic lymph nodes were detected in specimens in which a maximum number of 19 lymph nodes had been originally recovered, we strongly suggest a resampling of pT3N0 rectal specimens if less than 20 lymph nodes have been recovered.
KW - Lymph node yield
KW - Perirectal tissue sampling
KW - Quality standard
KW - Rectal cancer
UR - http://www.scopus.com/inward/record.url?scp=33751544199&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33751544199&partnerID=8YFLogxK
U2 - 10.1007/s00428-006-0313-3
DO - 10.1007/s00428-006-0313-3
M3 - Article
C2 - 17091252
AN - SCOPUS:33751544199
VL - 449
SP - 647
EP - 651
JO - Virchows Archiv - A Pathological Anatomy and Histopathology
JF - Virchows Archiv - A Pathological Anatomy and Histopathology
SN - 0945-6317
IS - 6
ER -