Colorectal surgeons and biomedical scientists improve lymph node harvest in colorectal cancer

The aim of this study was to review lymph node retrieval from colorectal cancer resections. We examined consecutive, single colorectal cancers excised between September 1999 and February 2007. Data gathered included patient age and gender, cancer location, total number of lymph nodes and involved lymph nodes identified. The speciality of the operating surgeon was recorded. Whether a pathologist or biomedical scientist was responsible for harvesting lymph nodes from the resected specimen was also noted. A total of 1,194 patients were identified. Increased numbers of lymph nodes identified was associated with increased lymph node positivity (p < 0.001, r=0.121). Biomedical scientists identified more lymph nodes (median 15, range 12-20) within specimens than consultant pathologists (median 10, range 7-13; p < 0.001). Colorectal surgeons removed more lymph nodes (median 11, range 7-15) than non-colorectal surgeons (median 9, range 7-14; p=0.002). There was a significant increase in lymph node harvesting over time and this correlated with lymph node positivity. Lymph node harvest was significantly higher when the resection was performed by a colorectal surgeon and when the specimen was examined by a biomedical scientist. For accurate staging and consequent correct planning of adjuvant treatment and prognosis, resections should be performed by a colorectal surgeon and the lymph nodes harvested by a biomedical scientist.