It is difficult to imagine, based on the current data, that an im

It is difficult to imagine, based on the current data, that an improvement in survival could be observed as LNCs increase, since increasing LNCs are so closely tied to increasing

stage, and increasing stage is itself tied to worse OS. We recognize that our inability to demonstrate an improvement in survival with increasing LNCs does not preclude Inhibitors,research,lifescience,medical the existence of such a relationship. In fact, larger studies have provided more definitive information on this relationship (5,15). It is worth pointing out that large studies like these are crucial in detecting such phenomena since institutionally based studies would be much less likely to uncover them. Patient-level studies AZD-2281 remain important; however, because they provide more granular clinical data that when analyzed teases out the why and the how Inhibitors,research,lifescience,medical behind observations from population-based studies. Combining individual institutional studies should improve the productivity of this type of study. Perhaps the most important role of these patient-level studies could be to inform and improve the population-based registries by suggesting which additional data should be collected by these organizations. The current study examines the relationship between

LNCs in resected rectal cancer Inhibitors,research,lifescience,medical and various clinico-pathologic factors. Higher LNCs were associated with younger age, higher stage, diagnosis in the later period of our study, and performance Inhibitors,research,lifescience,medical of MRE. We could not demonstrate a decrease in lymph node counts among patients treated with neoadjuvant chemoradiotherapy. Examination of the relationship between lymph node counts and 5-yr OS failed to demonstrate any improvements in survival with higher LNCs. In fact, the opposite effect of higher LNCs was observed. Based on the apparent differences between rectal cancer and colon cancer, we believe separate selleck chem Enzalutamide recommendations for minimum lymph node counts should be developed, based on population-based data. We also believe that LNCs in patients treated with preoperative chemoradiotherapy should be separately analyzed to

determine appropriate quality benchmarks. Finally, recalling that LNC is not the only important factor, Inhibitors,research,lifescience,medical Batimastat institutionally based studies should continue to identify other factors that influence outcomes after rectal cancer treatment. These factors could then be considered for inclusion in the data collection efforts of large population-based registries. Acknowledgements Disclosure: The authors declare no conflict of interest.
Pancreatic cytopathology is increasingly being recognized as a safe, rapid, reliable, accurate and cost effective modality in the evaluation of patients with a mass lesion. It has surpassed pancreatic wedge and core needle biopsies with their attendant increased risk of complications (fistulas, hemorrhage, and tumor seeding) as a first line pathologic investigative procedure (1). Optimal results require a dedicated approach, experience and expertise by all professionals involved.

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