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Barriers to Optimal Assessment of Lymph Nodes in Colorectal Cancer Specimens

Frances C. Wright MD, FRCSC, Calvin H.L. Law MD, MPH, FRCSC, Linda D. Last CCRP, Rosalie Ritacco, Deepa Kumar MD, FRCSC, Eugene Hsieh MD, FRCPC, Mahmoud Khalifa MD, PhD, FRCPC, Andrew J. Smith MD, MSc, FRCSC
DOI: http://dx.doi.org/10.1309/17VKM33BFXF9T8WD 663-670 First published online: 1 May 2004


Lymph node (LN) retrieval and assessment is critically important for accurate staging and treatment planning in colorectal cancer (CRC). Practicing pathologists in Ontario were identified and surveyed by phone to identify barriers to optimal retrieval and assessment. Of the pathologists surveyed, 57.9% were aware of guidelines for LN retrieval in CRC, but only 25.0% identified that a minimum of 12 LNs are necessary for accurate designation of node negativity. An important role exists for an education strategy aimed at bridging the knowledge gap among practicing pathologists and surgeons regarding optimal LN assessment in CRC specimens.

Key Words:
  • Colorectal cancer
  • Lymph node assessment
  • Education
  • Barriers to practice change
  • Cancer staging