Lymph node yield is critical to reliable tumor staging.
What is a lymph node? Lymph nodes are small structures in the lymphatic system that work as filters for harmful substances. Lymph nodes are examined to determine the presence of metastatic tumor in surgically resected specimens.
Stop spending valuable time hunting for lymph nodes
MANUAL SEARCH
TIME: Dissecting colorectal cancer specimens can take up to 60 minutes for a thorough manual search.
GOAL: find at minimum 12 lymph nodes
RESULT: only a portion of the total lymph nodes are found manually, risking the cancer-positive lymph nodes are missed
14
Mean lymph nodes per case using manual search
SEARCH
TIME: Runtime is <2 minutes. Mechanical filtration removes fat, shrinking the sample to 1/5th of its previous size.
GOAL: find all surgically resected lymph nodes in the specimen
RESULT: a consistent and standardized process of evaluating adipose from the colon specimen in its entirety
Skilled surgeons are trained to remove a precise margin of tissue containing lymph nodes that is adjacent to the primary tumor. The purpose of collecting nearby lymph nodes is to asses if the patient’s cancer is spreading through the lymphatic system. If cancer positive lymph nodes are detected, therapeutics will likely be prescribed to further treat the patient. AdiPress leads to a rigorous review of lymph nodes, enabling a higher degree in staging confidence. Today, labs manual sample lymph nodes, resulting is fewer lymph nodes found, leading to risk of patients being mis-staged.
ACCURATE TNM STAGING
Medical oncologists want greater confidence that staging is precise given the implications for treatment planning and eligibility for clinical trials.
For lab directors, this should also reduce the concerns about medical liability, as they will be able to show a record that they prepared all the nodes for analysis.
If we believe they may be missing positive nodes in 10-20% of all cases in colorectal cancer specimens today, then reducing that number to less than 1% would represent a huge advance.
"CENSUS-LEVEL NODAL ASSESSMENT
Defined as preparing and submitting all lymph nodes that were resected by the surgical oncologist, or a general GI surgeon, and delivered to the AP Lab.
STANDARDIZATION OF NODE ANALYSIS
Implies that all specimens will be processed in the same manner, eliminating all the operator-dependent variability associated with manual procedures. Surgeons will appreciate the consistency of this approach and prefer this to the “luck of the draw” they experience now where node assessments can vary based on the skill, training and experience of the lab staff, and the time they spend, when assigned to a case.
EFFICIENCY ENHANCEMENTS
As the dissection process can be performed in much less time with staff who are minimally trained in device operation. Lab Directors will appreciate the labor and cost saving associated with this new approach. With a predictable number of slides that will be generated for each specimen, the reviewing pathologists who sign the final reports will have more time to spend on each slide, with enhanced confidence regarding staging calls, and improving their relationships with the other members of the cancer care team.
