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International Journal of Surgical Oncology
Volume 2011, Article ID 406517, 6 pages
http://dx.doi.org/10.1155/2011/406517
Research Article

Same Surgeon: Different Centre Equals Differing Lymph Node Harvest following Colorectal Cancer Resection

1Department of Surgery, Singleton Hospital, Sketty, Swansea SA2 8QA, UK
2Alexandra Hospital, Worcester Acute Hospital NHS Trust, Redditch B98 7UB, UK
3Department of Surgery, Heart of England Foundation NHS Trust, Birmingham B9 5SS, UK
4Princess of Wales Hospital, Bridgend CF31 1RQ, UK
5Department of Pathology, Heart of England Foundation NHS Trust, Birmingham B9 5SS, UK

Received 17 August 2010; Accepted 12 January 2011

Academic Editor: Timothy M. Pawlik

Copyright © 2011 M. D. Evans et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The aim of this study was to examine the effect of surgeon relocation on lymph node (LN) retrieval in colorectal cancer (CRC) resection. Methods. The study population was 213 consecutive patients undergoing CRC resection by a single surgeon, at two units: unit one 110 operations (2002–2005) and unit two 103 (2005–2009). LN yields and case mix were compared. Results. Median LN harvests were significantly different between the two centres: unit 1: 13 nodes/patient and unit 2: 22 nodes/patient ( 𝑃 < . 0 0 1 ). In unit one 42% of cases were LN positive and in unit two 48% ( 𝑃 = . 3 9 8 ). There was no difference in case mix. Multivariate analysis identified unit ( 𝑃 < . 0 0 1 ) and pathologist ( 𝑃 = . 0 0 7 ) as independent predictors of harvest. Conclusions. A surgeon moving units can experience significantly different LN yield following CRC resection. Both units comply with national standards, but the “surgeon's results” at the two units appear to be pathologist dependent. This has implications for nodal harvest as a surrogate marker of surgical quality.