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Review of the quality of total mesorectal excision does not improve the prediction of outcome

(2016) COLORECTAL DISEASE. 18(9). p.883-888
Author
Organization
Abstract
Aim: A fair to moderate concordance in grading of the total mesorectal excision (TME) surgical specimen by local pathologists and a central review panel has been observed in the PROCARE (Project on Cancer of the Rectum) project. The aim of the present study was to evaluate the difference, if any, in the accuracy of predicting the oncological outcome through TME grading by local pathologists or by the review panel. Method: The quality of the TME specimen was reviewed for 482 surgical specimens registered on a prospective database between 2006 and 2011. Patients with a Stage IV tumour, with unknown incidence date or without follow-up information were excluded, resulting in a study population of 383 patients. Quality assessment of the specimen was based on three grades including mesorectal resection (MRR), intramesorectal resection (IMR) and muscularis propria resection (MPR). Using univariable Cox regression models, local and review panel histopathological gradings of the quality of TME were assessed as predictors of local recurrence, distant metastasis and disease-free and overall survival. Differences in the predictions between local and review grading were determined. Results: Resection planes were concordant in 215 (56.1%) specimens. Downgrading from MRR to MPR was noted in 23 (6.0%). There were no significant differences in the prediction error between the two models; local and central review TME grading predicted the outcome equally well. Conclusion: Any difference in grading of the TME specimen between local histopathologists and the review panel had no significant impact on the prediction of oncological outcome for this patient cohort. Grading of the quality of TME as reported by local histopathologists can therefore be used for outcome analysis. Quality control of TME grading is not warranted provided the histopathologist is adequately trained.
Keywords
COMPLETENESS, CLINICAL-SIGNIFICANCE, RECTAL-CANCER RESECTION, PROJECT, Total mesorectal excision, adenocarcinoma, rectum, oncological outcome

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MLA
Demetter, P et al. “Review of the Quality of Total Mesorectal Excision Does Not Improve the Prediction of Outcome.” COLORECTAL DISEASE 18.9 (2016): 883–888. Print.
APA
Demetter, P., Jouret-Mourin, A., Silversmit, G., Vandendael, T., Sempoux, C., Hoorens, A., Nagy, N., et al. (2016). Review of the quality of total mesorectal excision does not improve the prediction of outcome. COLORECTAL DISEASE, 18(9), 883–888.
Chicago author-date
Demetter, P, A Jouret-Mourin, G Silversmit, T Vandendael, C Sempoux, Anne Hoorens, N Nagy, Claude Cuvelier, N Van Damme, and F Penninckx. 2016. “Review of the Quality of Total Mesorectal Excision Does Not Improve the Prediction of Outcome.” Colorectal Disease 18 (9): 883–888.
Chicago author-date (all authors)
Demetter, P, A Jouret-Mourin, G Silversmit, T Vandendael, C Sempoux, Anne Hoorens, N Nagy, Claude Cuvelier, N Van Damme, and F Penninckx. 2016. “Review of the Quality of Total Mesorectal Excision Does Not Improve the Prediction of Outcome.” Colorectal Disease 18 (9): 883–888.
Vancouver
1.
Demetter P, Jouret-Mourin A, Silversmit G, Vandendael T, Sempoux C, Hoorens A, et al. Review of the quality of total mesorectal excision does not improve the prediction of outcome. COLORECTAL DISEASE. 2016;18(9):883–8.
IEEE
[1]
P. Demetter et al., “Review of the quality of total mesorectal excision does not improve the prediction of outcome,” COLORECTAL DISEASE, vol. 18, no. 9, pp. 883–888, 2016.
@article{8135065,
  abstract     = {Aim: A fair to moderate concordance in grading of the total mesorectal excision (TME) surgical specimen by local pathologists and a central review panel has been observed in the PROCARE (Project on Cancer of the Rectum) project. The aim of the present study was to evaluate the difference, if any, in the accuracy of predicting the oncological outcome through TME grading by local pathologists or by the review panel. 
Method: The quality of the TME specimen was reviewed for 482 surgical specimens registered on a prospective database between 2006 and 2011. Patients with a Stage IV tumour, with unknown incidence date or without follow-up information were excluded, resulting in a study population of 383 patients. Quality assessment of the specimen was based on three grades including mesorectal resection (MRR), intramesorectal resection (IMR) and muscularis propria resection (MPR). Using univariable Cox regression models, local and review panel histopathological gradings of the quality of TME were assessed as predictors of local recurrence, distant metastasis and disease-free and overall survival. Differences in the predictions between local and review grading were determined. 
Results: Resection planes were concordant in 215 (56.1%) specimens. Downgrading from MRR to MPR was noted in 23 (6.0%). There were no significant differences in the prediction error between the two models; local and central review TME grading predicted the outcome equally well. 
Conclusion: Any difference in grading of the TME specimen between local histopathologists and the review panel had no significant impact on the prediction of oncological outcome for this patient cohort. Grading of the quality of TME as reported by local histopathologists can therefore be used for outcome analysis. Quality control of TME grading is not warranted provided the histopathologist is adequately trained.},
  author       = {Demetter, P and Jouret-Mourin, A and Silversmit, G and Vandendael, T and Sempoux, C and Hoorens, Anne and Nagy, N and Cuvelier, Claude and Van Damme, N and Penninckx, F},
  issn         = {1462-8910},
  journal      = {COLORECTAL DISEASE},
  keywords     = {COMPLETENESS,CLINICAL-SIGNIFICANCE,RECTAL-CANCER RESECTION,PROJECT,Total mesorectal excision,adenocarcinoma,rectum,oncological outcome},
  language     = {eng},
  number       = {9},
  pages        = {883--888},
  title        = {Review of the quality of total mesorectal excision does not improve the prediction of outcome},
  url          = {http://dx.doi.org/10.1111/codi.13254},
  volume       = {18},
  year         = {2016},
}

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