alexa Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control


Journal of Blood & Lymph

Author(s): Nagtegaal ID, van de Velde CJ

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Search term Clear input Advanced Help NCBI will be testing https on public web servers from 1:00-4:00 PM EDT (17:00-20:00 UTC) on Monday, October 24. You may experience problems with NCBI services, especially file downloads, during that time. Please plan accordingly. Read more. Result Filters Format: Abstract Send to J Clin Oncol. 2002 Apr 1;20(7):1729-34. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. Nagtegaal ID1, van de Velde CJ, van der Worp E, Kapiteijn E, Quirke P, van Krieken JH; Cooperative Clinical Investigators of the Dutch Colorectal Cancer Group. Author information Abstract PURPOSE: Quality assessment and assurance are important issues in modern health care. For the evaluation of surgical procedures, there are indirect parameters such as complication, recurrence, and survival rates. These parameters are of limited value for the individual surgeon, and there is an obvious need for direct parameters. We have evaluated criteria by which pathologists can judge the quality or completeness of the resection specimen in a randomized trial for rectal cancer. PATIENTS AND METHODS: The pathology reports of all patients entered onto a Dutch multicenter randomized trial were reviewed. All participating pathologists had been instructed by workshops and videos in order to obtain standardized pathology work-up. A three-tiered classification was applied to assess completeness of the total mesorectal excision (TME). Prognostic value of this classification was tested using log-rank analysis of Kaplan-Meier survival curves using the data of all patients who did not receive any adjuvant treatment. RESULTS: Included were 180 patients. In 24% (n = 43), the mesorectum was incomplete. Patients in this group had an increased risk for local and distant recurrence, 36.1% v. 20.3% recurrence in the group with a complete mesorectum (P =.02). Follow-up is too short to observe an effect on survival rates. CONCLUSION: A patient's prognosis is predicted by applying a classification of macroscopic completeness on a rectal resection specimen. We conclude that pathologists are able to judge the quality of TME for rectal cancer. With this direct interdisciplinary assessment instrument, we establish a new role of the pathologist in quality control.

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This article was published in J Clin Oncol. 2002 and referenced in Journal of Blood & Lymph

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