Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer

C. C. Earle, M. R. Weiser, A. Ter Veer, J. M. Skibber, J. Wilson, A. Rajput, Y. N. Wong, Al B Benson III, S. Shibata, D. Romanus, J. Niland, D. Schrag

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Failing to meet the benchmark of 12 lymph nodes in resection specimens is an indication for adjuvant chemotherapy in stage II colon cancer. Methods: Among consecutive eligible patients with pathologic stage II colon cancer treated at eight NCI-designated comprehensive cancer centers between September 1, 2005 and February 19, 2008, we analyzed receipt of adjuvant chemotherapy, with less than 12 versus 12+ lymph nodes removed and examined the primary explanatory variable of interest. Results: Among 258 patients, 46% received adjuvant chemotherapy. An oxaliplatin-containing regimen was used 67% of the time. Younger age (<50 years, P<0.001), presence of lymphovascular invasion (P=0.007), and higher T stage (P=0.007) were independently associated with adjuvant chemotherapy use. There was significant inter-institutional variability in practice with the proportion receiving treatment ranging from 17% to 64% (P<0.05). Notably, presence of less than 12 lymph nodes in the surgical specimen was a strong predictor of treatment (P=0.008). Conclusions: Adjuvant chemotherapy use after resection of stage II colon cancer is common, but by no means standard practice at National Comprehensive Cancer Network (NCCN) institutions. More attention to achieving the recommended benchmark for lymph node dissection has the potential to decrease exposure to the toxicity of adjuvant treatment.

Original languageEnglish (US)
Pages (from-to)525-528
Number of pages4
JournalJournal of Surgical Oncology
Volume100
Issue number7
DOIs
StatePublished - Dec 1 2009

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Adjuvant Chemotherapy
Colonic Neoplasms
Lymph Nodes
Benchmarking
oxaliplatin
Lymph Node Excision
Neoplasms
Therapeutics

Keywords

  • Chemotherapy
  • Colon cancer
  • LN retrieval

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Earle, C. C., Weiser, M. R., Ter Veer, A., Skibber, J. M., Wilson, J., Rajput, A., ... Schrag, D. (2009). Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer. Journal of Surgical Oncology, 100(7), 525-528. https://doi.org/10.1002/jso.21373
Earle, C. C. ; Weiser, M. R. ; Ter Veer, A. ; Skibber, J. M. ; Wilson, J. ; Rajput, A. ; Wong, Y. N. ; Benson III, Al B ; Shibata, S. ; Romanus, D. ; Niland, J. ; Schrag, D. / Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer. In: Journal of Surgical Oncology. 2009 ; Vol. 100, No. 7. pp. 525-528.
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abstract = "Background: Failing to meet the benchmark of 12 lymph nodes in resection specimens is an indication for adjuvant chemotherapy in stage II colon cancer. Methods: Among consecutive eligible patients with pathologic stage II colon cancer treated at eight NCI-designated comprehensive cancer centers between September 1, 2005 and February 19, 2008, we analyzed receipt of adjuvant chemotherapy, with less than 12 versus 12+ lymph nodes removed and examined the primary explanatory variable of interest. Results: Among 258 patients, 46{\%} received adjuvant chemotherapy. An oxaliplatin-containing regimen was used 67{\%} of the time. Younger age (<50 years, P<0.001), presence of lymphovascular invasion (P=0.007), and higher T stage (P=0.007) were independently associated with adjuvant chemotherapy use. There was significant inter-institutional variability in practice with the proportion receiving treatment ranging from 17{\%} to 64{\%} (P<0.05). Notably, presence of less than 12 lymph nodes in the surgical specimen was a strong predictor of treatment (P=0.008). Conclusions: Adjuvant chemotherapy use after resection of stage II colon cancer is common, but by no means standard practice at National Comprehensive Cancer Network (NCCN) institutions. More attention to achieving the recommended benchmark for lymph node dissection has the potential to decrease exposure to the toxicity of adjuvant treatment.",
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Earle, CC, Weiser, MR, Ter Veer, A, Skibber, JM, Wilson, J, Rajput, A, Wong, YN, Benson III, AB, Shibata, S, Romanus, D, Niland, J & Schrag, D 2009, 'Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer', Journal of Surgical Oncology, vol. 100, no. 7, pp. 525-528. https://doi.org/10.1002/jso.21373

Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer. / Earle, C. C.; Weiser, M. R.; Ter Veer, A.; Skibber, J. M.; Wilson, J.; Rajput, A.; Wong, Y. N.; Benson III, Al B; Shibata, S.; Romanus, D.; Niland, J.; Schrag, D.

In: Journal of Surgical Oncology, Vol. 100, No. 7, 01.12.2009, p. 525-528.

Research output: Contribution to journalArticle

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T1 - Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer

AU - Earle, C. C.

AU - Weiser, M. R.

AU - Ter Veer, A.

AU - Skibber, J. M.

AU - Wilson, J.

AU - Rajput, A.

AU - Wong, Y. N.

AU - Benson III, Al B

AU - Shibata, S.

AU - Romanus, D.

AU - Niland, J.

AU - Schrag, D.

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Y1 - 2009/12/1

N2 - Background: Failing to meet the benchmark of 12 lymph nodes in resection specimens is an indication for adjuvant chemotherapy in stage II colon cancer. Methods: Among consecutive eligible patients with pathologic stage II colon cancer treated at eight NCI-designated comprehensive cancer centers between September 1, 2005 and February 19, 2008, we analyzed receipt of adjuvant chemotherapy, with less than 12 versus 12+ lymph nodes removed and examined the primary explanatory variable of interest. Results: Among 258 patients, 46% received adjuvant chemotherapy. An oxaliplatin-containing regimen was used 67% of the time. Younger age (<50 years, P<0.001), presence of lymphovascular invasion (P=0.007), and higher T stage (P=0.007) were independently associated with adjuvant chemotherapy use. There was significant inter-institutional variability in practice with the proportion receiving treatment ranging from 17% to 64% (P<0.05). Notably, presence of less than 12 lymph nodes in the surgical specimen was a strong predictor of treatment (P=0.008). Conclusions: Adjuvant chemotherapy use after resection of stage II colon cancer is common, but by no means standard practice at National Comprehensive Cancer Network (NCCN) institutions. More attention to achieving the recommended benchmark for lymph node dissection has the potential to decrease exposure to the toxicity of adjuvant treatment.

AB - Background: Failing to meet the benchmark of 12 lymph nodes in resection specimens is an indication for adjuvant chemotherapy in stage II colon cancer. Methods: Among consecutive eligible patients with pathologic stage II colon cancer treated at eight NCI-designated comprehensive cancer centers between September 1, 2005 and February 19, 2008, we analyzed receipt of adjuvant chemotherapy, with less than 12 versus 12+ lymph nodes removed and examined the primary explanatory variable of interest. Results: Among 258 patients, 46% received adjuvant chemotherapy. An oxaliplatin-containing regimen was used 67% of the time. Younger age (<50 years, P<0.001), presence of lymphovascular invasion (P=0.007), and higher T stage (P=0.007) were independently associated with adjuvant chemotherapy use. There was significant inter-institutional variability in practice with the proportion receiving treatment ranging from 17% to 64% (P<0.05). Notably, presence of less than 12 lymph nodes in the surgical specimen was a strong predictor of treatment (P=0.008). Conclusions: Adjuvant chemotherapy use after resection of stage II colon cancer is common, but by no means standard practice at National Comprehensive Cancer Network (NCCN) institutions. More attention to achieving the recommended benchmark for lymph node dissection has the potential to decrease exposure to the toxicity of adjuvant treatment.

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