Improving Care for Colorectal Cancer Patients
Evidence emerging nearly 20 years ago from studies of colorectal cancer patients undergoing surgical resection and lymph node removal in the area of the tumor, provided more information about whether or not the cancer was spreading and also was associated with improved survival.
Statistical review of that data determined that a minimum of 12 lymph nodes should be removed at the time of that surgery. For patients who had less than 12 nodes removed, there might be less information about how advanced their cancer is and those patients may not live as long as similar patient who had 12 or more removed. There are many reasons why less than 12 lymph nodes are recovered, ranging from the surgeon performing the operation to the location of the tumor in the colon to the individual characteristics of a particular patient. Nevertheless, the goal is to do 12 or more.
This became a national standard of care approximately 10 years ago, and the Phoebe Cancer Center has been tracking whether or not that standard is being met. While it is very challenging to reach 100% for some of the reasons mentioned above, the goal is to be as close to 100% as possible. It was noted in 2012 that the rate at Phoebe had dropped to 76% of patients from previous rates that were relatively high.
This signaled an opportunity to improve the performance of our program and help assure that we could get as close to 100% as possible. The Cancer Committee took on that challenge and through an educational effort that included educating the surgeons and the pathologists (the doctors who look at the cancer specimens through the microscope and actually retrieve the lymph nodes from tissue submitted by the surgeon) significant improvement has been made. The most recent review showed that over 97% of the patients who have surgery for colorectal cancer at Phoebe had 12 or more lymph nodes removed.
The education continues and every colorectal cancer case that is presented at the multidisciplinary tumor conference includes a discussion of the number of lymph nodes removed. In 2013, 53 patients had colorectal surgery at Phoebe. The Phoebe Cancer Center is committed to assuring that each and every one is receiving the nationally recognized standard of care.
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NCCN Guidelines Version 2.2015 Colon Cancer