According to a U.S. study, patients with pancreatic or stomach cancer may have more lymph nodes examined for the spread of cancer if they are treated at hospitals or at designated comprehensive cancer centers that do a high number of cancer surgeries.
According to background information in the study, if too few lymph nodes are examined for cancer cells, a patient's cancer may be incorrectly classified, altering prognosis, treatment decisions and eligibility for clinical trials. Current guidelines for pancreatic and stomach patients recommend examination of at least 15 regional lymph nodes.
The researchers examined National Cancer Data Base records of 1,130 pancreatic cancer patients and 3,088 stomach cancer patients. Of the pancreatic cancer patients, 19 percent had surgery at NCCN-NCI hospitals, 43.3 percent at other academic hospitals, and 37.7 percent at community hospitals.
Of the stomach cancer patients, 11.6 percent had surgery at a hospital designated as a National Cancer Institute (NCI) comprehensive cancer center or as part of the National Comprehensive Cancer Network (NCCN-NCI hospitals), 34 percent had surgery at other academic hospitals (affiliated with a medical school but not designated as NCCN-NCI facilities), and 54.4 percent had surgery at community hospitals.
Overall, according to the study, 16.4 percent of pancreatic cancer patients and 23.2 percent of stomach cancer patients had at least 15 lymph nodes evaluated. Patients at high-volume or NCCN-NCI hospitals were more likely to have at least 15 lymph nodes examined compared with patients at community or low-volume hospitals.
The researchers wrote that nodal status is a powerful forecaster of outcome, and every reasonable attempt should be made to assess the optimal number of lymph nodes to accurately stage disease in patients with pancreatic and gastric (stomach) cancer. In addition, differences in nodal evaluation may contribute to improved long-term outcomes at NCCN-NCI centers and high-volume hospitals for patients with pancreatic and gastric cancer.
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