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Lymph Node Evaluation Varies by Hospital Type and Volume

In gastric and pancreatic cancer, examination rates are higher at designated cancer centers

MONDAY, July 21 (HealthDay News) -- In patients with gastric or pancreatic cancer, lymph node evaluation is significantly more comprehensive at National Comprehensive Cancer Network (NCCN), National Cancer Institute (NCI)-designated institutions and at high-volume hospitals, according to a report published in the July issue of the Archives of Surgery.

Karl Y. Bilimoria, M.D., of the American College of Surgeons in Chicago, and colleagues accessed 2003-2004 data from the National Cancer Data Base on 3,088 patients who underwent resection for gastric cancer and 1,130 patients who underwent resection for pancreatic cancer.

The researchers found that evaluation of at least 15 lymph nodes was conducted in only 23.2 percent of gastric cancer patients and 16.4 percent of pancreatic cancer patients. They also found that the median number of lymph nodes examined was significantly higher at NCCN-NCI hospitals than at community hospitals (12 versus six for gastric cancer, and nine versus six for pancreatic cancer) and at high-volume hospitals than at low-volume hospitals (10 versus six for gastric cancer, and eight versus six for pancreatic cancer).

"Further investigation is needed to identify the reasons for better lymph node examination rates at NCCN-NCI centers and high-volume hospitals and to transfer those processes to low-volume and community hospitals," the authors conclude. "Examination of at least 15 lymph nodes is an appropriate quality surveillance measure for gastric and pancreatic cancer because it is a feasible, achievable and modifiable factor that is associated with improved outcomes."

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