MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Lymph node evaluation for colon cancer in an era of quality guidelines: who improves?

Citation Type: Journal Article

Publication Year: 2013

ISSN: 1935-469X

DOI: 10.1200/JOP.2012.000812

PMID: 23942934

Abstract: INTRODUCTION In the 1990s, several organizations began recommending evaluation of > 12 lymph nodes during colon resection because of its association with improved survival. We examined practice implications of multispecialty quality guidelines over the past 20 years recommending evaluation of ≥ 12 lymph nodes during colon resection for adequate staging. MATERIALS AND METHODS We used the 1988 to 2009 Surveillance, Epidemiology, and End Results program to conduct a retrospective observational cohort study of 90,203 surgically treated patients with colon cancer. We used Cochran-Armitage tests to examine trends in lymph node examination over time and multivariate logistic regression to identify patient characteristics associated with guideline-recommended lymph node evaluation. RESULTS The introduction of practice guidelines was associated with gradual increases in guideline-recommended lymph node evaluation. From 1988 to 1990, 34% of patients had > 12 lymph nodes evaluated, increasing to 38% in 1994 to 1996 and to > 75% from 2006 to 2009. Younger, white patients and those with more-extensive bowel penetration (T3/4 nonmetastatic) and high tumor grade saw more-rapid increases in lymph node evaluation (P < .001). Multivariate analyses demonstrated a significant interaction between year of diagnosis and both T stage and grade, indicating that those with higher T stage and higher grade were more likely to receive guideline-recommended care earlier. CONCLUSION The implementation of lymph node evaluation guidelines was accepted gradually into practice but adopted more quickly among higher risk patients. By identifying patients who are least likely to receive guideline-recommended care, these findings present a starting point for promoting targeted improvements in cancer care and further understanding underlying contributors to these disparities.

Url: http://ascopubs.org/doi/10.1200/JOP.2012.000812

Url: http://www.ncbi.nlm.nih.gov/pubmed/23942934

Url: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3710184

User Submitted?: No

Authors: Parsons, Helen M.; Begun, James W; Kuntz, Karen M; Tuttle, Todd M.; McGovern, Patricia M; Virnig, Beth A

Periodical (Full): Journal of oncology practice

Issue: 4

Volume: 9

Pages: e164-71

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop