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Screening Lots of Lymph Nodes Little Help for Colon Cancer Patients
Date:9/13/2011

p>Still, there was an association between the number of lymph nodes evaluated and survival. Patients who had more lymph nodes evaluated had a greater chance of surviving for five years than those with none or just a few nodes evaluated.

For example, patients with no nodes evaluated were 1.2 times more likely to die than those who had one to eight nodes evaluated regardless of whether the nodes were found to be cancerous or not. Patients who had between 12 and 15 nodes evaluated were 17 percent less likely to die than those who only had between one and eight evaluated; patients who had more than 40 nodes evaluated had a 36 percent decreased risk of death.

Put another way, about 55.4 percent of patients with no nodes evaluated died within five years; that dropped to 46.6 percent of those who had 12 to 15 evaluated and 33.3 percent of those who had more than 40 nodes evaluated.

But since there wasn't a strong link between evaluating more nodes and finding more cancers, researchers concluded that other qualities about the doctors or the hospitals may explain the differences in survival rates, rather than the node evaluation itself.

"Patients who had a large number of lymph nodes evaluated were only slightly more likely to be lymph node-positive than those who had only a few lymph nodes evaluated, and yet the group that got more lymph nodes evaluated had significantly lower mortality," Parsons said. "That suggests that something else . . . is the primary mechanism by which we are seeing the relationship."

Lymph node evaluation is one measure that's being used to assess hospital quality, but the study calls into question whether it's a useful measure, Parsons said. The National Quality Forum and several surgical consensus panels all recommend testing 12 or more lymph nodes, Parsons said.

Prior research has shown that if cancer is going to be found in lymph nodes, the chances are it will be found in the first five or so lymph nodes, an
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