Increased lymph node harvest from colorectal cancer resections using GEWF solution: a randomised study.

BACKGROUND

The lymph node harvest from colorectal specimens is pivotal for patients with colorectal cancer (CRC), independent of N stage.

AIMS

To determine whether the use of GEWF solution (glacial acetic acid, ethanol, distilled water and formaldehyde) could improve the lymph node harvest in CRC specimens.

METHODS

Consecutive fresh colonic (n = 60) and rectal (n = 60) specimens from patients with primary CRC resected at Aarhus University Hospital THG between March 2006 and July 2007 were randomised to either conventional preparation or GEWF preparation and examined in a standard manner.

RESULTS

For colonic as well as rectal specimens, the GEWF solution increased the mean lymph node harvest from 9 and 10 to 16 and 17 lymph nodes per specimen compared to conventional prepared specimens (p<0.001). Using the recommended threshold of 12 lymph nodes to ensure adequacy of nodal harvest, the adequacy increased from less than half to almost three quarters independent of tumour origin (p<0.037). The proportion of node-negative specimens was not significantly different between the two preparation groups.

CONCLUSION

The use of GEWF solution in patients with CRC significantly increases the lymph node harvest of resected specimens.