{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:43:59Z","timestamp":1784371439672,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,7,28]],"date-time":"2018-07-28T00:00:00Z","timestamp":1532736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>Lymph node (LN<\/jats:styled-content>) status is key to determining the need for adjuvant therapy in colorectal cancer (CRC) and for disease which has progressed to Stage II<\/jats:styled-content> (T3\u2013T4, N0, M0). A yield of fewer than 12 LN<\/jats:styled-content>s is considered a risk factor similar to high\u2010grade histology and vascular, lymphatic and perineural invasion. The aim of this retrospective study was to investigate the effect of acetone fat clearance of the mesocolon or mesorectum on LN<\/jats:styled-content> yield and the identification of patients with high\u2010risk Stage II CRC<\/jats:styled-content>.<\/jats:p><\/jats:sec>Method<\/jats:title>After conventional LN<\/jats:styled-content> retrieval, fatty tissue derived from the mesocolon or mesorectum of 80 CRC<\/jats:styled-content> specimens was incubated in acetone for 24 h. A second dissection was then performed by a trained technician. The total number of LNs as well as tumour involvement (LN<\/jats:styled-content>positive and LN<\/jats:styled-content>negative) were assessed at each stage. In addition, LN<\/jats:styled-content> morphology was assessed and clinicopathological data were extracted from existing pathology reports.<\/jats:p><\/jats:sec>Results<\/jats:title>Eighty CRC<\/jats:styled-content> specimens were available for study. 1548 (94%) LN were negative and 96 (6%) were positive. The median (range) LN<\/jats:styled-content> yield per specimen was 12 (3\u201341) LN increasing to 18 (4\u201348) LN after fat clearance (P<\/jats:italic> < 0.001). After fat clearance, 534 additional LN<\/jats:styled-content>s were identified in 75 (94%) of the specimens, and all but 10 were negative. The pN<\/jats:styled-content> stage did not change in six patients who were found to be LN<\/jats:styled-content> positive after fat clearance. However, the number of high\u2010risk Stage II CRC<\/jats:styled-content> patients decreased from 11 to 7. Although important for these patients, this downstaging did not reach statistical significance (P<\/jats:italic> = 0.125).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Acetone clearance of mesocolic or mesorectal fat increases median LN<\/jats:styled-content> yield and may in a larger study decrease the number of patients classified as having high\u2010risk Stage II CRC<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14335","type":"journal-article","created":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T10:42:28Z","timestamp":1531219348000},"page":"1014-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Acetone clearance of mesocolic or mesorectal fat increases lymph node yield and may improve detection of high\u2010risk Stage II colorectal cancer patients"],"prefix":"10.1111","volume":"20","author":[{"given":"C. A. 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E.","family":"Fazzi","sequence":"additional","affiliation":[{"name":"Department of Pathology and GROW\u2010School for Oncology and Developmental Biology Maastricht University Medical Center+ Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Melenhorst","sequence":"additional","affiliation":[{"name":"Department of Surgery Maastricht University Medical Center+ Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Rennspiess","sequence":"additional","affiliation":[{"name":"Department of Pathology and GROW\u2010School for Oncology and Developmental Biology Maastricht University Medical Center+ Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. I.","family":"Grabsch","sequence":"additional","affiliation":[{"name":"Department of Pathology and GROW\u2010School for Oncology and Developmental Biology Maastricht University Medical Center+ Maastricht The Netherlands"},{"name":"Pathology and Tumour Biology Leeds Institute of Cancer and Pathology University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198602000-00001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.03.058"},{"key":"e_1_2_8_4_1","first-page":"602","article-title":"More extensive nodal dissection improves survival for stages I to III of colon cancer: a population\u2010based study","volume":"244","author":"Chen SL","year":"2006","journal-title":"Ann Surg"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"vi64","DOI":"10.1093\/annonc\/mdt354","article-title":"Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow\u2010up","volume":"24","author":"Labianca R","year":"2014","journal-title":"Ann Oncol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.05.062"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0892-7"},{"key":"e_1_2_8_8_1","volume-title":"TNM Classification of malignant tumours","author":"Sobin LH","year":"1997"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10540"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji020"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181d7789d"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v8.i5.466"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3816\/CCC.2010.n.022"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2009.09.001"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2013-202146"},{"key":"e_1_2_8_16_1","first-page":"223","article-title":"Lymph node revealing solutions: a prospective study on 35 patients with colorectal carcinomas","volume":"40","author":"Saleki S","year":"2002","journal-title":"Acta Med Iran"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896912457204"},{"key":"e_1_2_8_18_1","unstructured":"Colorectaalcarcinoom (Versie 3.0). 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