Erschienen in:
29.03.2019 | Colorectal Cancer
The Value of Commission on Cancer Accreditation: Improving Survival Outcomes by Enhancing Compliance with Quality Measures
verfasst von:
Subhasis Misra, MD, MS, FACCWS, FACS, Ji Fan, MD, MBA, Ujwal Yanala, MD, Chandrakanth Are, MD, MBA
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 6/2019
Einloggen, um Zugang zu erhalten
Excerpt
In the United States, colorectal cancer is the third leading cause of cancer-related deaths in men and women and the second combined leading cause of cancer deaths.
1 Nodal staging accuracy for colorectal carcinoma is one of the most important determinant for prognosis and the selection of patients for adjuvant chemotherapy.
2 The American College of Pathologists in its consensus statement in 1999 defined accurate nodal staging to be a Category 1 prognostic factor and recommended that all identified lymph nodes be sectioned and a minimum of 12 lymph nodes be examined to accurately identify the American Joint Committee on Cancer (AJCC) stage III colon cancer.
3 The AJCC 5th edition recommended obtaining at least 12 lymph nodes in radical colon resection, whereas AJCC 6th edition modified the recommendation to obtain at least 7–14 lymph nodes.
4,
5 The AJCC 7th edition modified this again to obtain at least 10–14 lymph nodes in radical colorectal resection.
6 The AJCC 8 has not changed the N staging but clarified prognostic values of isolated tumor cells in lymph nodes (N0) and micrometastases (N1).
7 In its up-to-date guideline version 4.2018, the National Comprehensive Cancer Network (NCCN) has maintained that examination of a minimum of 12 lymph nodes must be one of the principles of colon cancer surgery.
8 Failing to retrieve 12 lymph nodes in resection specimens is an indication for consideration of adjuvant chemotherapy in stage II colon cancer.
8 Therefore, the efforts to achieve the recommended benchmark has the potential to decrease patient’s unnecessary exposure to the toxicity of adjuvant treatment.
9 …
