Introduction: Adequate lymph node harvest (at least 12) from colorectal cancer resection specimens has become a standard of care, influencing both staging and survival. To improve lymph node harvests in our hospital, a physicians assistant in the Department of Pathology was trained to harvest as many lymph nodes as possible from colorectal cancer specimens. An analysis of trends in lymph node harvest over time in our community hospital is presented.
Methods: Pathology reports were retrospectively reviewed of the number of lymph nodes harvested from 391 consecutive colorectal adenocarcinoma specimens in a single community hospital over an 8 year period (1999-2006). This spanned 4 years prior to the training of the physicians assistant and 4 years after.
Results: In the following table, results are given for each year in terms of average lymph node harvest and percent of specimens greater than 12 lymph nodes.Comparing 1999-2002 with 2003-2006, the difference in the average lymph node harvest reaches a p-value of <0.00001 (T-test). Comparing the number of specimens with at least 12 lymph nodes between 1999-2002 and 2003-2006, the difference reaches a p-value of <0.00001 (Chi-square).
Conclusions: As the awareness of the importance of adequate lymph node harvests in colorectal cancer specimens increased, lymph node harvests at our hospital steadily increased. The training of a physicians assistant to meticulously harvest as many lymph nodes as possible from colorectal cancer specimens dramatically affected lymph node harvests and can be a crucial component of pathologic analysis of these specimens.

Year	# of Specimens	Mean # of Lymph Nodes	% Specimens with > 11 Lymph Nodes
1999	18	13.3	67%
2000	48	12.2	50%
2001	53	14.3	55%
2002	49	14.4	67%
Training of PA
2003	40	20.7	83%
2004	50	20.6	84%
2005	75	18.4	87%
2006	58	20.0	86%