Hospitals Check Lymph Nodes After Colon Cancer Surgery Unnecessarily

After someone has had colon cancer surgery, standard protocol is to check the lymph nodes to detect how far the cancer has spread. Many hospitals are now using lymph nodes as a way to measure the quality of colon cancer surgery. In a recent press release, researchers state that this is not a true indicator of quality, and the practice should be disbanded.

While checking 12 lymph nodes after colon cancer surgery has been endorsed by the National Quality Forum, researchers from the University of Michigan question using this practice a measurement of the quality of colon cancer surgery.

Each hospital requires that a different number of lymph nodes be removed and analyzed. However, researchers determined that examining a specific number of lymph nodes did not have any correlation to how long a patient survived after having colon cancer surgery.

Researchers determined that hospitals with patients who had 12 or more lymph nodes examined usually treated colon cancer patients who had lower risks of complications or having a cancer that had spread. They also tended to have more surgeries performed than hospitals that treated more high-risk patients.

The difference between low-risk and high-risk operations at different hospitals was statistically adjusted. In doing so, researchers determined that there was no statistical correlation between examining lymph nodes and survival.

"These findings suggest that the momentum to implement a 12-node minimum as a quality indicator for hospitals performing colectomies for colon cancer should be slowed to allow for further investigation," said Sandra Wong, M.D., M.S., a University of Michigan surgical oncologist, and member of the University of Michigan Comprehensive Cancer Center.

Wong continued, "Everyone is vested in improving cancer care, but at the end of the day, there are only so many resources we can use for this. If we spend a lot of resources to enact the 12-node exam as the standard of care, we're going to miss the opportunity to improve in other ways."

In conducting this study, researchers analyzed data on over 30,000 patients who had been treated for colon cancer and had lymph nodes examined as a part of their procedure. None of the patients whose records were analyzed had cancer that had spread beyond their colon.

Colon cancer is the third most common type of cancer. It claims over 655,000 deaths every year around the world.

The full report is being published in the Journal of the American Medical Association.

Source:
http://www.med.umich.edu/opm/newspage/2007/lymphnodes.htm
http://en.wikipedia.org/wiki/Colorectal_cancer