Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Hence, pathological evaluations of patients with colon cancershould consist of a complete assessment of the LNs containedwithin the resected specimen. The number of metastatic LNsidentified may be influenced by the total number of LNsexamined, thus increasing the probability of stage migration.(Le Voyer, Sigurdson et al. 2003) Some studies have reported that increasing the number of LNsevaluated at the time of curative resection in patients with coloncancer is associated with improved survival (Le Voyer, Sigurdson et al. 2003, West, Hohenberger et al. 2009) The number ofLNs retrieved from a patient with colon cancer has been identifiedas a potentially important measure of the quality of cancer careby many organizations, including the American College ofSurgeons, the American Society of Clinical Oncology, theNational Comprehensive Cancer Network (NCCN), varioushealth insurance providers, and others. A minimum of 12examined LNs at curative resection is now advocated as a quality measure and is recommended for proper staging. Despite theserecommendations, however, a previous national cancer databasestudy that evaluated colectomies performed in nearly 1300hospitals reported that only 37% of the studied cases achieved atleast 12 LNs and that the median number of recovered LNs between 1988 and 2000 in the United States was 9

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