Almost two thirds of the hospitals are not adequately reviewed to colon cancer patients for signs that their tumor spreads, says a study that advises patients to request a thorough review before undergoing surgery.
The national guidelines say that when remove cancerous tumors of the colon, doctors should consider at least twelve lymph nodes to detect possible signs of spreading. Reviewing least twelve is not considered sufficient to ensure that the cancer is contained.
But a study of nearly 1,300 hospitals found that overall only 38% full compliance with that rule, researchers reported on Tuesday from Northwestern University in the journal of the National Cancer Institute.
"It's something very simple thing we can do to try to improve care for our patients," said Kyle author central Bilimoria of Northwestern and the American College of Surgeons.
Approximately 148,000 patients in the United States are diagnosed each year the disease. For many, the examination of the nodules can be decisive. The penetration of cancer elsewhere in the body is a decisive factor in the long-term survival of the patient, which helps doctors determine who should receive chemotherapy after an operation and who do not need it.
"Patients who could benefit from additional chemotherapy may not be receiving a full course of treatment and are most likely to relapse," said Dr. Golden Brooks of the American Oncology Society, which did not participate in the study. "It's something that consumers should begin to ask ... Frankly, this is likely to change medical practice."
To examine sufficient nodules, surgeons must remove a sufficient amount of fat tissue along the colon where they hide, and pathologists must carefully dissect the tissue to find the tiny nodules.
Previous studies have estimated that up to half of all colon cancer patients were examined at least twelve nodules. The study Bilimoria is the first to check what hospitals are more likely to comply with the guidelines, and report the findings directly to each institution.
His team examined a national database in search of cancer registries on what hospitals examined twelve or more lymph nodes in at least 75% of patients in 2004 and 2005, the latest data.
