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Correspondence |

Association With a High Number of Lymph Nodes and Microsatellite Instability in Colorectal Cancer—Reply

Clarisse Eveno, MD; Judith Nemeth, MD; Hany Soliman, MD; Françoise Praz, MD, PhD; Hugues de The, MD, PhD; Patrice Valleur, MD; Ian C. Talbot, MD, PhD; Marc Pocard, MD, PhD
Arch Surg. 2010;145(8):799-800. doi:10.1001/archsurg.2010.147.
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We thank Kjetil Søreide and coauthors for their interesting comments. It is important to confirm our results, as they are reported in another recent publication, using another statistical analysis. Whatever the analysis, the association between a particular tumor pathway, MSI, and a specific number of isolated lymph nodes are of major interest as outlined by Berho and Wexner.1

This observation is about surgery, but is not just for surgeons or pathologists. Surgery is a key component of public health systems around the world, specifically for cancer care. Colon cancer is the most common gastrointestinal malignancy and the second-leading cause of death in the United States.2 The need to improve quality, innovation, and evaluation in surgery has been considered major objectives.3 In that triad of interest, many efforts have been made in the last 10 years around evaluation.4 Nodal involvement is an important factor predicting long-term survival in digestive tract cancer. Numerous studies have shown an improvement in disease-specific and overall survival when elevated numbers of lymph nodes are reported for colon cancer.4 It was intriguing that most authors associated this high number with quality of care and not with a specific reaction to the tumor.

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August 1, 2010
Kjetil Søreide, MD, PhD; Bjørn S. Nedrebø, MD; Jon Arne Søreide, MD, PhD; Hartwig Kørner, MD, PhD
Arch Surg. 2010;145(8):799. doi:10.1001/archsurg.2010.146.
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