Colorectal adenocarcinoma: quality of the assessment of lymph node metastases

Dis Colon Rectum. 1994 Apr;37(4):373-6; discussion 376-7. doi: 10.1007/BF02053600.


Purpose: We have studied 193 cases of colorectal adenocarcinoma from a population-based register to determine the minimum number of lymph nodes to be examined to provide an accurate assessment of the presence of nodal metastases.

Methods: The mean total number of lymph nodes identified per surgical specimen was 11 +/- 6.8 (range, 1-36) using traditional dissection. One hundred eighteen specimens (61 percent) were classified as Dukes B. Seventy-five (39 percent) had lymph node metastases (Dukes C) with a mean of 3.3 +/- 4.7 positive lymph nodes per specimen. With binomial distribution we calculate the probability to find at least one positive node in a sample size n with a determined proportion of positive nodes.

Results: The error probability in the ganglionar assessment by traditional dissection was 0.05 with 6 examined lymph nodes and 0.01 with 10 examined nodes.

Conclusion: We must provide the pathologist with a minimum of six examined lymph nodes per surgical specimen for an optimal Dukes B assessment.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Colorectal Neoplasms / pathology*
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Registries
  • Reproducibility of Results