Lymph node yield following colorectal cancer surgery

Abstract

Background: Lymph node yield (LNY) is a measure of quality of care and a strong prognostic factor for outcome from colorectal cancer (CRC). The main aims of this study were to determine LNY across multiple Australian centres and the clinico-pathologic factors that influence yield. Methods: Analysis of data from prospective CRC databases at 11 Australian centres between January 1988 and May 2008 was undertaken utilizing the linkage and analysis resources of BioGrid Australia. The LNY depending on different clinico-pathologic patient characteristics was evaluated. Results: In total, 10 082 cases (54.1% men, 45.9% women) were identified. Median LNY was 12 (range 0–174). LNY increased significantly (P < 0.001) over time, from a mean of 8.5 in 1988 to 13 in 2008. LNY also varied significantly between surgical centres. Female gender, younger age, right-sided disease, higher T and N stage, specific operation types and absence of preoperative radiotherapy were all significantly associated with higher LNY. Conclusions: While varying across centres, the median LNYs in Australia are acceptable and have improved significantly over recent years. Multiple clinico-pathologic factors significantly influence the number of nodes retrieved.