Conservative Lymph Node Sampling Is Clinically Appropriate in Intestinal Resections Related to Nonneoplastic Inflammatory Bowel Disease.

Mayer, Chen; Liang, Tom Z; Karimi, Saman; Zhang, Yujie; Larman, Tatianna; Voltaggio, Lysandra

Mayer, Chen; Liang, Tom Z; Karimi, Saman; Zhang, Yujie; Larman, Tatianna; Voltaggio, Lysandra.

Afiliación

Mayer C; From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.
Liang TZ; From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.
Karimi S; From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.
Zhang Y; From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.
Larman T; From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.
Voltaggio L; From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.

Arch Pathol Lab Med ; 2024 Sep 06.

Article en En | MEDLINE | ID: mdl-39237110

ABSTRACT

ABSTRACT

CONTEXT. In this era of health care challenges, efficient resource use is crucial. Patients with inflammatory bowel disease (IBD) may undergo surgery owing to treatment-refractory disease or strictures. Unlike colorectal cancer resections, there are no guidelines for lymph node retrieval in nonmalignant IBD resections. OBJECTIVE. To assess the usefulness and cost-effectiveness of extensive lymph node examination in nonmalignant IBD resections. DESIGN. A retrospective analysis of 354 cases from 2011 to 2018 was conducted. Resections for suspected malignancy or lesions grossly suggestive of carcinoma were excluded. Patient data, resection type, lymph node count, and follow-up information were collected. RESULTS. Results showed 51% (180) of cases had 12 or more examined lymph nodes. Only 1 case (0.3%) revealed microscopic invasive carcinoma associated with stricture without metastasis to 26 examined lymph nodes. No metastatic disease was found among the 4972 evaluated lymph nodes. Estimated total savings were at least $19 812, with approximately 10.4 minutes saved on microscopic evaluation. During a mean 5.7-year follow-up, no patients developed metastatic disease from an intestinal primary tumor. Among the 20 deceased patients, cause of death was available for 14 patients (70%), of whom 11 (55%) died of nonneoplastic causes and 3 (15%) of nonintestinal malignancies. CONCLUSIONS. While lymph node assessment is crucial in IBD-associated colorectal carcinoma, a colorectal cancer protocol-type lymph node search is unnecessary without clinical or gross pathologic suspicion. A conservative approach to lymph node sampling optimizes resources without compromising patient care.

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arch Pathol Lab Med Año: 2024 Tipo del documento: Article País de afiliación: Israel Pais de publicación: Estados Unidos

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