EP573 - A Retrospective Analysis of Lymph Node Harvest Between Private Hospital Systems and Academic Institutions After Oncologic Colorectal Resections.

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Purpose/Background: Colorectal cancer is the second leading cause of cancer related deaths in the United States. Lymph node involvement is the greatest prognostic indicator for patients with nonmetastatic colon cancer and is a significant determinant of outcomes. At least twelve lymph nodes are recommended for accurate lymph node harvest. Current literature shows that there may be a difference in the number of lymph nodes examined due to specific pathologists and surgeon experience. Anecdotally, it has been noticed by a single colorectal surgery practice that certain private centers tend to have greater lymph node harvests on pathology reports when compared to local academic institutions. The purpose of this study is to determine whether there is a difference in the number of lymph nodes obtained in surgical specimens between private hospital systems and academic institutions based on a single practices experience in Northwest Louisiana. We hypothesize that the private institutions will have significantly larger lymph node yields statistically.

Methods/Interventions: We performed a retrospective chart review of a total of 36 patients from the local academic institution and 74 patients that underwent partial colectomies at our private institutions between January 1, 2021 and September 1, 2024. We targeted patients who underwent oncologic resections with curative intent performed laparoscopically or open. Patients were excluded if they were less than 18 years old, pre-op diagnosis was benign disease or stage IV cancer, robotic cases, emergency cases (diagnosis < 72 hours) or if medical or pathological data were incomplete. Pathology reports were then accessed to determine the amount of lymph nodes examined. A total of 58 patients met inclusion criteria with 14 from the academic hospital and 44 from private hospitals. The average lymph nodes between the two groups were compared using an unpaired t-test.

Results/Outcomes: The average number of lymph nodes assessed in the private hospital specimens were 24.64 and the average for the academic hospital were 19.36 with a difference of 5.28 (95% CI -1.4 - 11.9, P= 0.117).

Conclusion/Discussion: While we did notice a trend to greater lymph nodes harvested in the private system there was no statistically significant difference found between them and the public academic institution. This outcome was likely affected by the small number of available patients and the low power of the study. This study is also biased by focusing on a single colorectal surgery practice involving three surgeons and may not be generalizable to all populations. Future research involving larger numbers of hospitals, surgeons, pathologists and patients would be beneficial to fully understanding the major factors affecting lymph node harvests for colorectal resections as well as other oncologic specialties.