Immunohistochemistry is very useful tool in differentiating between primary lung cancer metastasizing to gastrointestinal tract and metastatic GI tumors in equivocal cases. Surgical therapy is not usually indicated for metastatic GI lesions originated from lung cancer due to their unfavorable outcome. However, surgical intervention is typically necessitated to prevent life-threatening GI events such as bleeding, obstruction and perforation thus providing
effective palliation as well as long-term survival in patients with only a solitary GI metastasis. Acknowledgements Disclosure: The find more authors declare no conflict of interest.
Colorectal cancer is the fourth leading cause of cancer and the second Inhibitors,research,lifescience,medical leading cause of cancer death in the U.S. each year. In the absence of distant metastatic Inhibitors,research,lifescience,medical disease, the status of the regional lymph nodes is the most powerful prognostic factor (1). Decisions regarding adjuvant chemotherapy and chemoradiotherapy are based, in large part, on the presence or absence of regional lymph node involvement. Given the importance of regional lymph node status, efforts to improve the accuracy of nodal staging are justified. Inhibitors,research,lifescience,medical The accuracy
of lymph node staging improves as the number of lymph nodes pathologically examined increases (1). This observation, which has been made in both colon and rectal cancer, has led to consensus recommendations that at least 12 lymph nodes be identified and subjected to histological examination in both Inhibitors,research,lifescience,medical colon and rectal cancer (2). This recommendation has gained strength, and an additional degree of importance, since the more recent publication of studies that demonstrate that survival after resection for colorectal cancer improves as the number of lymph nodes examined
increases. Inhibitors,research,lifescience,medical Indeed, those evaluating the quality of care delivered in colon and rectal cancers are becoming interested in using this recommendation as a quality benchmark for both diseases (3,4). This identical recommendation for minimum lymph node examination in both colon and rectal cancer seems to ignore two important points. It is generally understood that lymph node counts are consistently lower in rectal Sitaxentan cancer specimens compared to colon cancer specimens. Second, the body of evidence supporting an association between higher lymph node counts and improved survival is heavily weighted to analyses of colon cancer rather than rectal cancer. Since the impact of lymph node counts in rectal cancer seems less clear, we performed a retrospective review to determine whether lymph node counts correlated with 5-yr OS and to explore the relationship between lymph node counts and various clinical and pathologic factors. Patients and methods Through a search of our institutional tumor registry, we identified 190 patients with AJCC Stage 1, 2, or 3 rectal adenocarcinoma that underwent surgical resection in our hospital system over an eleven-year period (01/01/1995 through 12/31/2005).