Stage migration vs immunology: The lymph node count story in colon cancer

Table 7 Upstaging rates after re-evaluation

First author	Year	n	Mean LN before	Mean LN after	UpstagingN0/N+	Up-rate	Location	Technique	Comment
Scott	1989	103	6.2	12.4	Yes	8.6%	CR	Fat clearing	5yFU available
Haboubi	1992	41	6.7	58.2	Yes	28%1	CR	Fat clearing	Based on HE; higher up-staging with ICH1
Cohen	1994	41	13	17	?1	1	CR	Xylene	Upstaging in 1 single case; primary N-stage (N0/1) not given; %tage N+ not given1
Koren	1997	30	2.6	8.6	Yes	31%	CR	Fat clearing
Brown	2005	15	20.8	89.6	Yes	1	CR	ESMT	1 of 7; however unclear wether it was a LN metastasis or a deposit1
Kim	2007	48	19.4	43	No	/	CR	ESMT
Richter	2007	188	n.m.	n.m.	Yes	min 4%	CR	Fat clearing	Initinal insuff rate 59; after 9
Vogel	2008	80	6.9	11.3	Yes	2%	CR	Fat clearing
Märkl	2008	30	17	25	Yes	3%	C	Fat clearing	Primarily conventional technique
Märkl	2008	30	35	40	No	/	C	Fat clearing	Primarily methylen technique
Fan	2010	115	9.1	14.2	Yes	5%-10%1	CR	Re-evaluation	Insuff Rate 79%; Up Staging rate not exactly calculatable
Hernanz	2010	50	13.9	23.9	Yes	4%1	CR	Fat clearing	based on own calculation
Chapman	2012	94	22.5	29	Yes	1	CR	Schwartz-clearing	1 single case upstaged1
Chen	2014	83	7.2	14.1	No	/	CR	Re-evaluation: partly Fat clearing
Ma	2014	55	9.8	18.4	Yes1	1	CR	GEWF	Upstaging in cases with primary insufficient LNY; 3 cases N0 to N+1

¹See comment in the same row. CR: Colorectal; C: Colon; ESMT: Entire submission of mesenteric tissue; GEWF: Glacial acetic acid, ethanol, distilled water, formaldehyde; LN: Lymph node.