Ex vivo dissection increases lymph node yield in oesophagogastric cancer

Adam Cichowitz, Paul Robert Burton, Wendy Ann Brown, Andrew Ian Smith, Kalai Shaw, Ron Slamowicz, Peter Nottle

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Background: Retrieval and analysis of an adequate number of lymph nodes is critical for accurate staging of oesophageal and gastric cancer. Higher total node counts reported by pathologists are associated with improved survival. A prospective study was undertaken to understand the factors contributing to variability in lymph node counts after oesophagogastric cancer resections and to determine whether a novel strategy of ex vivo dissection of resected specimens into nodal stations improves node counts reported by pathologists. Methods: The study involved 88 patients with potentially curable oesophagogastric cancer undergoing radical resection. Lymph node counts were obtained from pathology reports and analysed in relation to multiple variables including the introduction of ex vivo dissection of nodal stations in theatre. Results: Higher lymph node counts were obtained with ex vivo dissection of nodal stations (median 19 versus 8, P <0.01). Node counts also varied significantly with the reporting pathologist (median range 4 to 48, P = 0.02) which was independent of the level of experience of the pathologist (P = 0.67). Node counts were not affected by patient age (P = 0.26), gender (P = 0.50), operative approach (P = 0.50) or neoadjuvant therapy (P = 0.83). Conclusions: Specimen handling is a significant factor in determining lymph node yield following radical oesophageal and gastric cancer resections. Ex vivo dissection of resected specimens into nodal stations improves node counts without alterations to surgical techniques. Ex vivo dissection should be considered routine.
Original languageEnglish
Pages (from-to)80 - 84
Number of pages84
JournalANZ Journal of Surgery
Volume85
Issue number1-2
DOIs
Publication statusPublished - 2015

Cite this

Cichowitz, Adam ; Burton, Paul Robert ; Brown, Wendy Ann ; Smith, Andrew Ian ; Shaw, Kalai ; Slamowicz, Ron ; Nottle, Peter. / Ex vivo dissection increases lymph node yield in oesophagogastric cancer. In: ANZ Journal of Surgery. 2015 ; Vol. 85, No. 1-2. pp. 80 - 84.
@article{8e9fabc8e99d4a55bd2b37e15218877a,
title = "Ex vivo dissection increases lymph node yield in oesophagogastric cancer",
abstract = "Background: Retrieval and analysis of an adequate number of lymph nodes is critical for accurate staging of oesophageal and gastric cancer. Higher total node counts reported by pathologists are associated with improved survival. A prospective study was undertaken to understand the factors contributing to variability in lymph node counts after oesophagogastric cancer resections and to determine whether a novel strategy of ex vivo dissection of resected specimens into nodal stations improves node counts reported by pathologists. Methods: The study involved 88 patients with potentially curable oesophagogastric cancer undergoing radical resection. Lymph node counts were obtained from pathology reports and analysed in relation to multiple variables including the introduction of ex vivo dissection of nodal stations in theatre. Results: Higher lymph node counts were obtained with ex vivo dissection of nodal stations (median 19 versus 8, P <0.01). Node counts also varied significantly with the reporting pathologist (median range 4 to 48, P = 0.02) which was independent of the level of experience of the pathologist (P = 0.67). Node counts were not affected by patient age (P = 0.26), gender (P = 0.50), operative approach (P = 0.50) or neoadjuvant therapy (P = 0.83). Conclusions: Specimen handling is a significant factor in determining lymph node yield following radical oesophageal and gastric cancer resections. Ex vivo dissection of resected specimens into nodal stations improves node counts without alterations to surgical techniques. Ex vivo dissection should be considered routine.",
author = "Adam Cichowitz and Burton, {Paul Robert} and Brown, {Wendy Ann} and Smith, {Andrew Ian} and Kalai Shaw and Ron Slamowicz and Peter Nottle",
year = "2015",
doi = "10.1111/ans.12365",
language = "English",
volume = "85",
pages = "80 -- 84",
journal = "ANZ Journal of Surgery",
issn = "1445-1433",
publisher = "Wiley-Blackwell",
number = "1-2",

}

Ex vivo dissection increases lymph node yield in oesophagogastric cancer. / Cichowitz, Adam; Burton, Paul Robert; Brown, Wendy Ann; Smith, Andrew Ian; Shaw, Kalai; Slamowicz, Ron; Nottle, Peter.

In: ANZ Journal of Surgery, Vol. 85, No. 1-2, 2015, p. 80 - 84.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Ex vivo dissection increases lymph node yield in oesophagogastric cancer

AU - Cichowitz, Adam

AU - Burton, Paul Robert

AU - Brown, Wendy Ann

AU - Smith, Andrew Ian

AU - Shaw, Kalai

AU - Slamowicz, Ron

AU - Nottle, Peter

PY - 2015

Y1 - 2015

N2 - Background: Retrieval and analysis of an adequate number of lymph nodes is critical for accurate staging of oesophageal and gastric cancer. Higher total node counts reported by pathologists are associated with improved survival. A prospective study was undertaken to understand the factors contributing to variability in lymph node counts after oesophagogastric cancer resections and to determine whether a novel strategy of ex vivo dissection of resected specimens into nodal stations improves node counts reported by pathologists. Methods: The study involved 88 patients with potentially curable oesophagogastric cancer undergoing radical resection. Lymph node counts were obtained from pathology reports and analysed in relation to multiple variables including the introduction of ex vivo dissection of nodal stations in theatre. Results: Higher lymph node counts were obtained with ex vivo dissection of nodal stations (median 19 versus 8, P <0.01). Node counts also varied significantly with the reporting pathologist (median range 4 to 48, P = 0.02) which was independent of the level of experience of the pathologist (P = 0.67). Node counts were not affected by patient age (P = 0.26), gender (P = 0.50), operative approach (P = 0.50) or neoadjuvant therapy (P = 0.83). Conclusions: Specimen handling is a significant factor in determining lymph node yield following radical oesophageal and gastric cancer resections. Ex vivo dissection of resected specimens into nodal stations improves node counts without alterations to surgical techniques. Ex vivo dissection should be considered routine.

AB - Background: Retrieval and analysis of an adequate number of lymph nodes is critical for accurate staging of oesophageal and gastric cancer. Higher total node counts reported by pathologists are associated with improved survival. A prospective study was undertaken to understand the factors contributing to variability in lymph node counts after oesophagogastric cancer resections and to determine whether a novel strategy of ex vivo dissection of resected specimens into nodal stations improves node counts reported by pathologists. Methods: The study involved 88 patients with potentially curable oesophagogastric cancer undergoing radical resection. Lymph node counts were obtained from pathology reports and analysed in relation to multiple variables including the introduction of ex vivo dissection of nodal stations in theatre. Results: Higher lymph node counts were obtained with ex vivo dissection of nodal stations (median 19 versus 8, P <0.01). Node counts also varied significantly with the reporting pathologist (median range 4 to 48, P = 0.02) which was independent of the level of experience of the pathologist (P = 0.67). Node counts were not affected by patient age (P = 0.26), gender (P = 0.50), operative approach (P = 0.50) or neoadjuvant therapy (P = 0.83). Conclusions: Specimen handling is a significant factor in determining lymph node yield following radical oesophageal and gastric cancer resections. Ex vivo dissection of resected specimens into nodal stations improves node counts without alterations to surgical techniques. Ex vivo dissection should be considered routine.

UR - http://onlinelibrary.wiley.com/doi/10.1111/ans.12365/pdf

U2 - 10.1111/ans.12365

DO - 10.1111/ans.12365

M3 - Article

VL - 85

SP - 80

EP - 84

JO - ANZ Journal of Surgery

JF - ANZ Journal of Surgery

SN - 1445-1433

IS - 1-2

ER -