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Study Challenges Colon Cancer Surgery Follow-Up
Date:11/13/2007

Routine testing of 12 lymph nodes may not be as useful as thought, researchers say

TUESDAY, Nov. 13 (HealthDay News) -- A new study is questioning the conventional wisdom of checking on the health of 12 lymph nodes after colon cancer surgery.

These post-op checks have been thought to be a good indicator of patient survival, but new data is casting that notion in doubt.

"What we are finding is that focusing on this quality indicator may not have much positive value for predicting patient outcome," said the study's lead author, Dr. Sandra L. Wong, assistant professor of surgery at the University of Michigan, Ann Arbor.

Wong's team published its report in the Nov. 14 issue of the Journal of the American Medical Association.

The routine examination of 12 lymph nodes after colon cancer surgery has been endorsed by the National Quality Forum, a respected organization backed by such prestigious bodies as the American Cancer Society and the American Society of Clinical Oncology.

However, the Michigan study of more than 30,000 people who underwent colon cancer surgery provided no support for the protocol.

One expert wasn't surprised by the results.

"People have been interpreting information relating the number of nodes examined and survival in a very simplistic way," said Dr. Nancy N. Baxter, assistant professor of surgery at the University of Toronto and co-author of an accompanying editorial. "That relationship is probably pretty complex, due at least in part to the underlying biology of the tumor," she said.

Using information from the Medicare-linked National Surveillance and End Results data base, Wong's team divided hospitals where the surgery was done into four groups, based on the proportion of patients who had 12 or more lymph nodes examined.

They then assessed patient survival rates for each group of hospitals, adjusting for patient and doctor chara
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