More is better: Lymph node harvesting in colorectal cancer
Abstract Introduction We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. Methods A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resectio...
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Veröffentlicht in: | The American journal of surgery 2017-05, Vol.213 (5), p.926-930 |
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description | Abstract Introduction We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. Methods A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 2008 and September 2013 was performed. Results Three hundred seventy-one patients had open and 110 had laparoscopic resections. There was no difference between open (17.85) and laparoscopic (18.91) approaches (p = 0.171) in the number of lymph nodes harvested. Patients who had more nodes removed tended toward improved survival, independent of stage (p = 0.052), an effect that was more pronounced in the open resection group (p = 0.031). There was no difference in survival between the open and laparoscopic groups overall (HR 1.52, p = 0.208). Discussion No survival advantage was found between the open and laparoscopic resection groups, affirming that the choice of operative approach for CRC does not affect the quality of the oncologic procedure in a community hospital setting. Patients who had more lymph nodes removed tended toward improved survival. The explanation for this effect remains unclear. |
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Methods A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 2008 and September 2013 was performed. Results Three hundred seventy-one patients had open and 110 had laparoscopic resections. There was no difference between open (17.85) and laparoscopic (18.91) approaches (p = 0.171) in the number of lymph nodes harvested. Patients who had more nodes removed tended toward improved survival, independent of stage (p = 0.052), an effect that was more pronounced in the open resection group (p = 0.031). There was no difference in survival between the open and laparoscopic groups overall (HR 1.52, p = 0.208). Discussion No survival advantage was found between the open and laparoscopic resection groups, affirming that the choice of operative approach for CRC does not affect the quality of the oncologic procedure in a community hospital setting. Patients who had more lymph nodes removed tended toward improved survival. The explanation for this effect remains unclear.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2017.03.012</identifier><identifier>PMID: 28438260</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Adult ; Age ; Aged ; Aged, 80 and over ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - surgery ; Communities ; Female ; Harvesting ; Hospitals ; Humans ; Kaplan-Meier Estimate ; Laparoscopy ; Lymph Node Excision - methods ; Lymph nodes ; Lymphatic system ; Male ; Middle Aged ; Patients ; Retrospective Studies ; Studies ; Surgery ; Survival ; Survival Rate ; Treatment Outcome</subject><ispartof>The American journal of surgery, 2017-05, Vol.213 (5), p.926-930</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited May 1, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-c127c4379540d40189e86c279c47ed1343e0a02844d55de1cf0dd0bf86b8eef13</citedby><cites>FETCH-LOGICAL-c448t-c127c4379540d40189e86c279c47ed1343e0a02844d55de1cf0dd0bf86b8eef13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1901359182?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993,64383,64385,64387,72239</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28438260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Boyle, S</creatorcontrib><creatorcontrib>Stephenson, K</creatorcontrib><title>More is better: Lymph node harvesting in colorectal cancer</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Introduction We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. Methods A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 2008 and September 2013 was performed. Results Three hundred seventy-one patients had open and 110 had laparoscopic resections. There was no difference between open (17.85) and laparoscopic (18.91) approaches (p = 0.171) in the number of lymph nodes harvested. Patients who had more nodes removed tended toward improved survival, independent of stage (p = 0.052), an effect that was more pronounced in the open resection group (p = 0.031). There was no difference in survival between the open and laparoscopic groups overall (HR 1.52, p = 0.208). Discussion No survival advantage was found between the open and laparoscopic resection groups, affirming that the choice of operative approach for CRC does not affect the quality of the oncologic procedure in a community hospital setting. Patients who had more lymph nodes removed tended toward improved survival. The explanation for this effect remains unclear.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Communities</subject><subject>Female</subject><subject>Harvesting</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Laparoscopy</subject><subject>Lymph Node Excision - methods</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU1v1DAQhi0EokvhJ4AiceGSMGM7idMDCFV8VNqqB-Bsee1J65CPxU4q7b_H0S4g9dKTNdIzr2eeYew1QoGA1fuuMEMXl3BbcMC6AFEA8idsg6puclRKPGUbAOB5UyGcsRcxdqlElOI5O-NKCsUr2LCL6ylQ5mO2o3mmcJFtD8P-LhsnR9mdCfcUZz_eZn7M7NQn1M6mz6wZLYWX7Flr-kivTu85-_nl84_Lb_n25uvV5adtbqVUc26R11aKuiklOAmoGlKV5XVjZU0OhRQEBtJE0pWlI7QtOAe7VlU7RdSiOGfvjrn7MP1e0kB68NFS35uRpiXqlJj2VVyu6NsHaDctYUzTaWwARZlInqjySNkwxRio1fvgBxMOGkGvcnWnT3L1KleD0Elu6ntzSl92A7l_XX9tJuDjEaCk495T0NF6Sq6cX81pN_lHv_jwIMH2fvTW9L_oQPH_NjpyDfr7euH1wFiL9biN-AMKsaAp</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>O'Boyle, S</creator><creator>Stephenson, K</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>More is better: Lymph node harvesting in colorectal cancer</title><author>O'Boyle, S ; Stephenson, K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-c127c4379540d40189e86c279c47ed1343e0a02844d55de1cf0dd0bf86b8eef13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Communities</topic><topic>Female</topic><topic>Harvesting</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Laparoscopy</topic><topic>Lymph Node Excision - methods</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Studies</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Boyle, S</creatorcontrib><creatorcontrib>Stephenson, K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Boyle, S</au><au>Stephenson, K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>More is better: Lymph node harvesting in colorectal cancer</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>213</volume><issue>5</issue><spage>926</spage><epage>930</epage><pages>926-930</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract Introduction We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. Methods A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 2008 and September 2013 was performed. Results Three hundred seventy-one patients had open and 110 had laparoscopic resections. There was no difference between open (17.85) and laparoscopic (18.91) approaches (p = 0.171) in the number of lymph nodes harvested. Patients who had more nodes removed tended toward improved survival, independent of stage (p = 0.052), an effect that was more pronounced in the open resection group (p = 0.031). There was no difference in survival between the open and laparoscopic groups overall (HR 1.52, p = 0.208). Discussion No survival advantage was found between the open and laparoscopic resection groups, affirming that the choice of operative approach for CRC does not affect the quality of the oncologic procedure in a community hospital setting. Patients who had more lymph nodes removed tended toward improved survival. The explanation for this effect remains unclear.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28438260</pmid><doi>10.1016/j.amjsurg.2017.03.012</doi><tpages>5</tpages></addata></record> |
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subjects | Abdomen Adult Age Aged Aged, 80 and over Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - mortality Colorectal Neoplasms - surgery Communities Female Harvesting Hospitals Humans Kaplan-Meier Estimate Laparoscopy Lymph Node Excision - methods Lymph nodes Lymphatic system Male Middle Aged Patients Retrospective Studies Studies Surgery Survival Survival Rate Treatment Outcome |
title | More is better: Lymph node harvesting in colorectal cancer |
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