TY  - JOUR
T1  - Predictors of lymph node count in colorectal cancer resections: Data from us nationwide prospective cohort studies
AU  - Morikawa T, Tanaka N, Kuchiba A, et al
Y1  - 2012/08/01
N1  - 10.1001/archsurg.2012.353
JO  - Archives of Surgery
SP  - 715
EP  - 723
VL  - 147
IS  - 8
N2  - Objective 
                  To identify factors that influence the total and negative lymph node counts in colorectal cancer resection specimens independent of pathologists and surgeons.Design 
                  We used multivariate negative binomial regression. Covariates included age, sex, body mass index, family history of colorectal carcinoma, year of diagnosis, hospital setting, tumor location, resected colorectal length (specimen length), tumor size, circumferential growth, TNM stage, lymphocytic reactions and other pathological features, and tumor molecular features (microsatellite instability, CpG island methylator phenotype, long interspersed nucleotide element 1 [LINE-1] methylation, and BRAF, KRAS, and PIK3CA mutations).Setting 
                  Two US nationwide prospective cohort studies.Patients 
                  Patients with rectal and colon cancer (N = 918).Main Outcome Measures 
                  The negative and total node counts (continuous).Results 
                  Specimen length, tumor size, ascending colon location, T3N0M0 stage, and year of diagnosis were positively associated with the negative node count (all P ≤ .002). Mutation of KRAS might also be positively associated with the negative node count (P = .03; borderline significance considering multiple hypothesis testing). Among node-negative (stages I and II) cases, specimen length, tumor size, and ascending colon location remained significantly associated with the node count (all P ≤ .002), and PIK3CA and KRAS mutations might also be positively associated (P = .03 and P = .049, respectively, with borderline significance).Conclusions 
                  This molecular pathological epidemiology study shows that specimen length, tumor size, tumor location, TNM stage, and year of diagnosis are operator-independent predictors of the lymph node count. These crucial variables should be examined in any future evaluation of the adequacy of lymph node harvest and nodal staging when devising individualized treatment plans for patients with colorectal cancer.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2012.353
UR  - http://dx.doi.org/10.1001/archsurg.2012.353
ER  -