Increased lymph node harvest from colorectal cancer resections using GEWF solution A randomized study

Abstract

Aims: The lymph node harvest from colorectal specimens is pivotal for colorectal cancer (CRC) patients, independent of N stage. This study was designed to determine whether the use of GEWF solution (glacial acetic acid, ethanol, destilled 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 randomized 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 quarter independent of tumor origin, P<0.037. The proportion of node-negative specimens did not differ statistical significantly among the two preparation groups.

Conclusion: The use of GEWF solution may have diagnostic and therapeutic consequences for CRC patients, since the lymph node harvest of their resected specimens increased statistical significantly.