In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 4_suppl ( 2013-02-01), p. 481-481
Abstract:
481 Background: Data on quality control of the pathologic evaluation of total mesorectal excision specimens are scarce. Differences between evaluation by local pathologists participating in PROCARE, a Belgian improvement project on rectal cancer, and a review panel were assessed. Methods: Based on photographic material and histopathology slides, a review committee of pathologists with a particular interest in colorectal pathology re-evaluated the mesorectal plane, the circumferential resection margin (CRM), the tumour differentiation grade, the (y)pT stage and the tumour regression grade (according to Dworak) in 444 cases (354 low anterior resection and 90 abdomino-perineal resection specimens). Results: The surgical plane was reported in 89% and the CRM in 88% of cases by the local pathologist. The median number of lymph nodes harvested in patients undergoing long-course neoadjuvant radiochemotherapy was 11, whereas this was 14 in the other patients. The review committee downgraded the surgical plane of 17% of patients from (intra)mesorectal to intramuscular, and upgraded it in 27% from intramuscular to (intra)mesorectal. Tumour differentiation grade, T stage and tumour regression grade differed between local pathologists and review committee in 15%, 10% and 38%, respectively. T stage was upgraded in 8% of cases, mainly from T2 to T3. Tumour regression was judged by the review panel to be less advanced in 15% of cases. Conclusions: Acknowledging some shortcomings (comparison between a photographical evaluation and an evaluation on a fresh specimen), this study gives a realistic view of clinical practice. There are differences in interpretation with regard to macroscopic and microscopic analysis of TME specimens. These findings indicate a need for more objective and reproducible criteria in histopathology. Being aware of this is a first step for improvement.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2013.31.4_suppl.481
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2013
detail.hit.zdb_id:
2005181-5
