Linking surgical specimen length and examined lymph nodes in @entity14 XXXX .

@entity1 @entity1803 @entity5 @entity14 @entity694
AIM: The number of examined lymph nodes (NLN) was associated with survival of stages II and III @entity14 ( @entity14 ) @entity1 . Guidelines recommend examining at least 12 lymph nodes. This study investigated the influence of surgical specimen length on lymph node harvest and compliance with international guidelines. MATERIALS AND METHODS: This population-based study included 4,724 cases of surgically treated @entity14 that were diagnosed from 2002 to 2008. Multivariate analyses were performed for the main study variables (age, gender, diagnosis at screening or in symptomatic @entity1 , @entity5 site, staging, grading, number of positive nodes, neo-adjuvant treatment for @entity5 , hospital were surgery was performed). Fractional polynomial models investigated the relationship between continuous variables and outcomes. RESULTS: The NLN increased over time reaching >= 12 NLN in 64% of cases at the end of the study period. More NLN were associated with young age, right @entity694 , @entity1803 -T4 disease, stages II and III and high grade. Fewer NLN were associated with short surgical specimen length and neo-adjuvant treatment in @entity5 @entity1 . Use of laparoscopy increased sharply over time. CONCLUSIONS: NLN increased over time in accordance with international guidelines. Surgical specimen length correlated with NLN which may determine therapeutic choices, particularly in @entity5 . When harvested lymph nodes are under 10 in number and all are negative, chemotherapy is always recommended. As specimen lengths <20  cm were associated with a high risk of inadequate NLN counts, @entity1 are at risk of over-treatment.
