Techniques to increase lymph node harvest from gastrointestinal cancer specimens: a systematic review and meta-analysis - Abbassi-Ghadi - Histopathology - Wiley Online Library

Good news/bad news. Another article supporting the use of fat clearing and methylene blue staining to increase lymph node yields in GI dissection BUT these techniques do not increase the identification of positive LNs or lead to upstaging.




From Evernote:




Techniques to increase lymph node harvest from gastrointestinal cancer specimens: a systematic review and meta-analysis - Abbassi-Ghadi - Histopathology - Wiley Online Library
Clipped from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2559.2012.04357.x/abstract;jsessionid=41CA356777E5BB95FA5D2064D29EC704.d04t02



Abstract:

Aim: This review aims to compare different histopathological techniques for lymph node harvest from ex vivo gastrointestinal cancer specimens and to examine their influence on: (i) lymph node yield; (ii) positive lymph node detection, and; (iii) cancer staging.

Method: Systematic review of the English language literature, comparing manual nodal dissection to other techniques for lymph node harvest, up to October 10th, 2011. Methodological quality of included studies was assessed.

Results: Twenty-seven studies, examining: fat clearing, methylene blue staining, fat stretching and use of a dedicated pathology assistant, were assessed. The methodological quality of the majority of included studies was poor. Meta-analysis showed that fat clearing and methylene blue staining increased mean lymph node yield, by 13 and 15 nodes respectively when compared to manual dissection. Of the 15 studies reporting positive lymph node count, two demonstrated a significant improvement for techniques other than manual dissection. Compared to manual dissection, other techniques were not shown to influence cancer staging.

Conclusion: This review has shown that fat clearing and methylene blue staining increases the mean lymph node yield from gastrointestinal cancer specimens. There is insufficient evidence to suggest that these techniques increase positive lymph node count or lead to upstaging.

© 2012 Blackwell Publishing Ltd