{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:19:18Z","timestamp":1792696758039,"version":"4.5.0"},"reference-count":56,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Context.<\/jats:italic>\n                    \u2014Nodal metastasis is one of the most important prognostic factors in colorectal carcinoma. The number of lymph nodes recovered and examined in resection specimens has been recently shown to be critical for proper staging and is associated with survival.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    \u2014To assess the clinicopathologic factors that may be associated with the number of lymph nodes harvested from surgical resections.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014Clinicopathologic factors of 434 consecutive cases of colorectal cancers treated by surgical resection from a single tertiary medical center were retrospectively reviewed and correlated with number of lymph nodes recovered.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014Our data show that patient age, tumor location, and length of resected bowel segment were associated with number of lymph nodes harvested in surgical resections of colorectal cancer. The average number of lymph nodes was 18.2 and 17.8 for patients younger than 50 years and aged 50 through 60 years, respectively, whereas it was 14.4, 15.1, and 14.9 for patients aged 61 through 70 years, 71 through 80 years, and 80 years and older, respectively. More lymph nodes were present in resection specimens of cecum\/ascending colon and descending colon cancers than in those of transverse colon, sigmoid colon, and rectal cancers. There was a linear increase in number of lymph nodes examined with increasing length of bowel resection specimens. In multivariate regression analysis, the factors that remained independent predictors of removal of 12 or more lymph nodes from resection specimens were tumor location and length of resected bowel segment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    \u2014The number of lymph nodes obtained in resection specimens for colorectal cancer was significantly associated with the length of resected segments of bowel, patient age, and location of the tumor.\n                  <\/jats:p>","DOI":"10.5858\/133.5.781","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T09:55:47Z","timestamp":1613123747000},"page":"781-786","source":"Crossref","is-referenced-by-count":64,"title":["Number of Lymph Nodes Examined and Associated Clinicopathologic Factors in Colorectal Carcinoma"],"prefix":"10.5858","volume":"133","author":[{"given":"Steven S.","family":"Shen","sequence":"first","affiliation":[{"name":"From the Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell University, Houston, Tex (Drs Shen and Ro); and the Departments of Pathology (Drs Haupt, Zhu, and Schwartz) and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Bailey), The Methodist Hospital, Houston, Tex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisong X.","family":"Haupt","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell University, Houston, Tex (Drs Shen and Ro); and the Departments of Pathology (Drs Haupt, Zhu, and Schwartz) and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Bailey), The Methodist Hospital, Houston, Tex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Y.","family":"Ro","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell University, Houston, Tex (Drs Shen and Ro); and the Departments of Pathology (Drs Haupt, Zhu, and Schwartz) and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Bailey), The Methodist Hospital, Houston, Tex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jijiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell University, Houston, Tex (Drs Shen and Ro); and the Departments of Pathology (Drs Haupt, Zhu, and Schwartz) and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Bailey), The Methodist Hospital, Houston, Tex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Randoph","family":"Bailey","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell University, Houston, Tex (Drs Shen and Ro); and the Departments of Pathology (Drs Haupt, Zhu, and Schwartz) and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Bailey), The Methodist Hospital, Houston, Tex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary R.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell University, Houston, Tex (Drs Shen and Ro); and the Departments of Pathology (Drs Haupt, Zhu, and Schwartz) and the Division of Colon and Rectal Surgery, Department of Surgery (Dr Bailey), The Methodist Hospital, Houston, Tex"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"key":"i1543-2165-133-5-781-b1","series-title":"CA Cancer J Clin","first-page":"43","article-title":"Cancer statistics, 2007.","volume":"57","author":"Jemal, A.","year":"2007","unstructured":"Jemal, A., R.Siegel, E.Ward, T.Murray, J.Xu, and M. J.Thun. Cancer statistics, 2007.CA Cancer J Clin2007. 57:43\u201366."},{"key":"i1543-2165-133-5-781-b2","series-title":"J Clin Oncol","first-page":"469","article-title":"A randomized trial of fluorouracil and folinic acid in patients with metastatic colorectal carcinoma.","volume":"6","author":"Erlichman, C.","year":"1988","unstructured":"Erlichman, C., S.Fine, A.Wong, and T.Elhakim. A randomized trial of fluorouracil and folinic acid in patients with metastatic colorectal carcinoma.J Clin Oncol1988. 6:469\u2013475."},{"key":"i1543-2165-133-5-781-b3","series-title":"Br J Cancer","first-page":"309","article-title":"The spread of rectal cancer and its effect on prognosis.","volume":"12","author":"Dukes, C. E.","year":"1958","unstructured":"Dukes, C. E. and H. J.Bussey. The spread of rectal cancer and its effect on prognosis.Br J Cancer1958. 12:309\u2013320."},{"key":"i1543-2165-133-5-781-b4","series-title":"Cancer","first-page":"1424","article-title":"The relationship of survival to staging and grading of colorectal carcinoma: a prospective study of 503 cases.","volume":"47","author":"Newland, R. C.","year":"1981","unstructured":"Newland, R. C., P. H.Chapuis, M. T.Pheils, and J. G.MacPherson. The relationship of survival to staging and grading of colorectal carcinoma: a prospective study of 503 cases.Cancer1981. 47:1424\u20131429."},{"key":"i1543-2165-133-5-781-b5","series-title":"Br J Surg","first-page":"698","article-title":"A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer.","volume":"72","author":"Chapuis, P. H.","year":"1985","unstructured":"Chapuis, P. H., O. F.Dent, and R.Fisher. et al. A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer.Br J Surg1985. 72:698\u2013702."},{"key":"i1543-2165-133-5-781-b6","series-title":"Ann Surg Oncol","first-page":"887","article-title":"Current issues in adjuvant treatment of stage II colon cancer.","volume":"13","author":"Andre, T.","year":"2006","unstructured":"Andre, T., D.Sargent, and J.Tabernero. et al. Current issues in adjuvant treatment of stage II colon cancer.Ann Surg Oncol2006. 13:887\u2013898."},{"key":"i1543-2165-133-5-781-b7","series-title":"Lancet Oncol","first-page":"515","article-title":"Should adjuvant chemotherapy become standard treatment for patients with stage II colon cancer?: for the proposal.","volume":"7","author":"Sobrero, A.","year":"2006","unstructured":"Sobrero, A.\n          \n          Should adjuvant chemotherapy become standard treatment for patients with stage II colon cancer?: for the proposal.\n          Lancet Oncol\n          2006. 7:515\u2013516."},{"key":"i1543-2165-133-5-781-b8","series-title":"Am J Clin Pathol","first-page":"209","article-title":"Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered.","volume":"106","author":"Goldstein, N. S.","year":"1996","unstructured":"Goldstein, N. S., W.Sanford, M.Coffey, and L. 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Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089.J Clin Oncol2003. 21:2912\u20132919."},{"key":"i1543-2165-133-5-781-b10","series-title":"J Clin Oncol","first-page":"3570","article-title":"Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer.","volume":"24","author":"Johnson, P. M.","year":"2006","unstructured":"Johnson, P. M., G. A.Porter, R.Ricciardi, and N. N.Baxter. Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer.J Clin Oncol2006. 24:3570\u20133575."},{"key":"i1543-2165-133-5-781-b11","series-title":"J Natl Cancer Inst","first-page":"433","article-title":"Lymph node evaluation and survival after curative resection of colon cancer: systematic review.","volume":"99","author":"Chang, G. J.","year":"2007","unstructured":"Chang, G. J., M. 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Impact of number of nodes retrieved on outcome in patients with rectal cancer.J Clin Oncol2001. 19:157\u2013163."},{"key":"i1543-2165-133-5-781-b14","series-title":"Cancer","first-page":"452","article-title":"TNM classification: clarification of number of regional lymph nodes for pNo.","volume":"92","author":"Sobin, L. H.","year":"2001","unstructured":"Sobin, L. H. and F. L.Greene. TNM classification: clarification of number of regional lymph nodes for pNo.Cancer2001. 92:452."},{"key":"i1543-2165-133-5-781-b15","series-title":"J Natl Cancer Inst","first-page":"583","article-title":"Guidelines 2000 for colon and rectal cancer surgery.","volume":"93","author":"Nelson, H.","year":"2001","unstructured":"Nelson, H., N.Petrelli, and A.Carlin. et al. Guidelines 2000 for colon and rectal cancer surgery.J Natl Cancer Inst2001. 93:583\u2013596."},{"key":"i1543-2165-133-5-781-b16","article-title":"AJCC Cancer Staging Manual. 6th ed.","author":"Greene, F. L.","unstructured":"Greene, F. L., D. 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Lymph node evaluation in colorectal cancer patients: a population-based study.J Natl Cancer Inst2005. 97:219\u2013225."},{"key":"i1543-2165-133-5-781-b19","series-title":"J Gastrointest Surg","first-page":"883","article-title":"Adequacy of nodal harvest in colorectal cancer: a consecutive cohort study [discussion in J Gastrointest Surg. 2002;6:889\u2013890].","volume":"6","author":"Johnson, P. M.","year":"2002","unstructured":"Johnson, P. M., D.Malatjalian, and G. A.Porter. Adequacy of nodal harvest in colorectal cancer: a consecutive cohort study [discussion in J Gastrointest Surg. 2002;6:889\u2013890].J Gastrointest Surg2002. 6:883\u2013888."},{"key":"i1543-2165-133-5-781-b20","series-title":"Ann Surg Oncol","first-page":"903","article-title":"Lymph node retrieval and assessment in stage II colorectal cancer: a population-based study.","volume":"10","author":"Wright, F. C.","year":"2003","unstructured":"Wright, F. C., C. H.Law, and L.Last. et al. Lymph node retrieval and assessment in stage II colorectal cancer: a population-based study.Ann Surg Oncol2003. 10:903\u2013909."},{"key":"i1543-2165-133-5-781-b21","series-title":"Dis Colon Rectum","first-page":"1333","article-title":"Anatomic study of the lymph nodes of the mesorectum.","volume":"44","author":"Canessa, C. E.","year":"2001","unstructured":"Canessa, C. E., F.Badia, S.Fierro, V.Fiol, and G.Hayek. Anatomic study of the lymph nodes of the mesorectum.Dis Colon Rectum2001. 44:1333\u20131336."},{"key":"i1543-2165-133-5-781-b22","series-title":"Dis Colon Rectum","first-page":"779","article-title":"Mesorectal lymph nodes: their location and distribution within the mesorectum.","volume":"46","author":"Topor, B.","year":"2003","unstructured":"Topor, B., R.Acland, V.Kolodko, and S.Galandiuk. Mesorectal lymph nodes: their location and distribution within the mesorectum.Dis Colon Rectum2003. 46:779\u2013785."},{"key":"i1543-2165-133-5-781-b23","series-title":"Virchows Arch","first-page":"133","article-title":"How many lymph nodes are necessary to stage early and advanced adenocarcinoma of the sigmoid colon and upper rectum?","volume":"443","author":"Leibl, S.","year":"2003","unstructured":"Leibl, S., O.Tsybrovskyy, and H.Denk. How many lymph nodes are necessary to stage early and advanced adenocarcinoma of the sigmoid colon and upper rectum?Virchows Arch2003. 443:133\u2013138."},{"key":"i1543-2165-133-5-781-b24","series-title":"Ann Surg","first-page":"458","article-title":"Prognostic evaluation of stage B colon cancer patients is improved by an adequate lymphadenectomy: results of a secondary analysis of a large scale adjuvant trial.","volume":"235","author":"Prandi, M.","year":"2002","unstructured":"Prandi, M., R.Lionetto, and A.Bini. et al. Prognostic evaluation of stage B colon cancer patients is improved by an adequate lymphadenectomy: results of a secondary analysis of a large scale adjuvant trial.Ann Surg2002. 235:458\u2013463."},{"key":"i1543-2165-133-5-781-b25","series-title":"Br J Surg","first-page":"58","article-title":"Clearance technique for the detection of lymph nodes in colorectal cancer.","volume":"73","author":"Cawthorn, S. J.","year":"1986","unstructured":"Cawthorn, S. J., N. M.Gibbs, and C. G.Marks. Clearance technique for the detection of lymph nodes in colorectal cancer.Br J Surg1986. 73:58\u201360."},{"key":"i1543-2165-133-5-781-b26","article-title":"Predicting the right number of lymph nodes\u2014the ACPGBI lymph node harvest model.","author":"Smith, J. J.","unstructured":"Smith, J. J., P. P.Tekkis, M. R.Thompson, and J. 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Current issues in adjuvant treatment of stage II colon cancer.Ann Surg Oncol2006. 13:887\u2013898."},{"key":"i1543-2165-133-5-781-b7","series-title":"Lancet Oncol","first-page":"515","article-title":"Should adjuvant chemotherapy become standard treatment for patients with stage II colon cancer?: for the proposal.","volume":"7","author":"Sobrero, A.","year":"2006","unstructured":"Sobrero, A.\n          \n          Should adjuvant chemotherapy become standard treatment for patients with stage II colon cancer?: for the proposal.\n          Lancet Oncol\n          2006. 7:515\u2013516."},{"key":"i1543-2165-133-5-781-b8","series-title":"Am J Clin Pathol","first-page":"209","article-title":"Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered.","volume":"106","author":"Goldstein, N. S.","year":"1996","unstructured":"Goldstein, N. S., W.Sanford, M.Coffey, and L. 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Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089.J Clin Oncol2003. 21:2912\u20132919."},{"key":"i1543-2165-133-5-781-b10","series-title":"J Clin Oncol","first-page":"3570","article-title":"Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer.","volume":"24","author":"Johnson, P. M.","year":"2006","unstructured":"Johnson, P. M., G. A.Porter, R.Ricciardi, and N. N.Baxter. Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer.J Clin Oncol2006. 24:3570\u20133575."},{"key":"i1543-2165-133-5-781-b11","series-title":"J Natl Cancer Inst","first-page":"433","article-title":"Lymph node evaluation and survival after curative resection of colon cancer: systematic review.","volume":"99","author":"Chang, G. J.","year":"2007","unstructured":"Chang, G. J., M. A.Rodriguez-Bigas, J. M.Skibber, and V. A.Moyer. Lymph node evaluation and survival after curative resection of colon cancer: systematic review.J Natl Cancer Inst2007. 99:433\u2013441."},{"key":"i1543-2165-133-5-781-b12","series-title":"Br J Surg","first-page":"1165","article-title":"Detection of lymph node metastases in colorectal carcinoma before and after fat clearance.","volume":"76","author":"Scott, K. W.","year":"1989","unstructured":"Scott, K. W. and R. H.Grace. Detection of lymph node metastases in colorectal carcinoma before and after fat clearance.Br J Surg1989. 76:1165\u20131167."},{"key":"i1543-2165-133-5-781-b13","series-title":"J Clin Oncol","first-page":"157","article-title":"Impact of number of nodes retrieved on outcome in patients with rectal cancer.","volume":"19","author":"Tepper, J. E.","year":"2001","unstructured":"Tepper, J. E., M. J.O'Connell, and D.Niedzwiecki. et al. 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