Colorectal cancer and lymph nodes: The obsession with the number 12
| Autor: | Stefano Puleo, Roberto Scilletta, Giovanni Li Destri, Scilletta B, Isidoro Di Carlo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Lymphatic metastasis Staging Colorectal cancer medicine.medical_treatment Research methodology Treatment outcome Lymph node ratio numero Linfonodi Stadiazione Medicine Humans Topic Highlight Neoplasm Staging integumentary system business.industry General surgery Gold standard Lymph node count Gastroenterology Lymphadenectomy General Medicine Cancro colon retto medicine.disease Prognosis United States Surgery Europe Treatment Outcome linfoadenectomia Linfonodi ratio Lymphatic Metastasis Lymph Node Excision Neoplasm staging Laparoscopy Lymph Lymph Nodes business Colorectal Neoplasms Colorectal cancer Lymphadenectomy Lymph node count Lymph node ratio Staging Cancro colon retto linfoadenectomia numero Linfonodi Linfonodi ratio Stadiazione |
| Popis: | Lymphadenectomy of colorectal cancer is a decisive factor for the prognostic and therapeutic staging of the patient. For over 15 years, we have asked ourselves if the minimum number of 12 examined lymph nodes (LNs) was sufficient for the prevention of understaging. The debate is certainly still open if we consider that a limit of 12 LNs is still not the gold standard mainly because the research methodology of the first studies has been criticized. Moreover many authors report that to date both in the United States and Europe the number "12" target is uncommon, not adequate, or accessible only in highly specialised centres. It should however be noted that both the pressing nature of the debate and the dissemination of guidelines have been responsible for a trend that has allowed for a general increase in the number of LNs examined. There are different variables that can affect the retrieval of LNs. Some, like the surgeon, the surgery, and the pathology exam, are without question modifiable; however, other both patient and disease-related variables are non-modifiable and pose the question of whether the minimum number of examined LNs must be individually assigned. The lymph nodal ratio, the sentinel LNs and the study of the biological aspects of the tumor could find valid application in this field in the near future. |
| Databáze: | OpenAIRE |
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