Proportion of rectal cancer resections where at least 12 lymph nodes are reported in pathology

Why this indicator is important

Rectal cancers are often grouped together with colon cancers, and this group of cancers is referred to as 'bowel cancer'.

There has been rapid development in the diagnosis and treatment of rectal cancer in the past decade. Management of rectal cancer often includes more than a single treatment. Treatment modalities include surgery, chemotherapy and radiotherapy.

The management of these cancers is complex and requires a team of health care professionals with experience in rectal cancer treatment who also provide appropriate care following treatment.

Evidence shows a positive association between the number of lymph nodes examined and survival for people with rectal cancer.1,2 To determine accurate cancer staging, clinical guidelines recommend collecting at least 12 associated pelvic lymph nodes during surgery for rectal cancer.3

About this indicator

This indicator relates to the number of pelvic lymph nodes collected during rectal cancer surgery, and examined by a pathologist.

  • Between 2013 and 2016, the proportion of people with 12 or more lymph nodes examined during surgery for rectal cancer ranged from 43% to 91% across LHDs

Proportion of cases with 12 or more lymph nodes examined (excluding cases receiving neoadjuvant therapy*), rectal cancer surgery, by local health district (LHD) of residence**, NSW, 20132016

Proportion of cases with 12 or more lymph nodes examined (excluding cases receiving neoadjuvant therapy*), rectal cancer surgery, by local health district (LHD) of residence**, NSW, 2013–2016

N = Number of rectal cancer cases with nodes collected during and examined following primary resection.

* Cases were excluded based on neoadjuvant therapy treatment data available in the NSW Cancer Registry (NSWCR) as of August 2019.

** LHD of residence relates to the address of residence at time of rectal cancer diagnosis.

Notes:

  1. Data source: NSW Cancer Registry (NSWCR).
  2. The number of nodes examined were recorded from pathology reports of the primary rectal cancer resection where present as a scanned image in the NSWCR. The NSWCR may not have a primary resection if the pathology report was missing or resections were performed interstate (cross-border patients)

References:

  1. Chang GJ, Rodriguez-Bigas MA, Skibber JM, Moyer VA. Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst, 2007. 99(6):433-41.
  2. Wong, SL. Lymph node counts and survival rates after resection for colon and rectal cancer. Gastrointest Cancer Res 2009 Mar–Apr;3(2 Suppl 1):S33–S35.
  3. Compton CC, Fielding PL, Burgart LJ, et al. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med. 2000 Jul;124(7):979–942.