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Pathologist second opinion significantly alters clinical management of pT1 endoscopically resected colorectal cancer

(2019) VIRCHOWS ARCHIV. 475(5). p.665-668
Author
Organization
Abstract
We retrospectively collected a series of 82 endoscopically removed early colorectal cancers. Histological specimens were revised by two gastrointestinal pathologists, performing a re-evaluation of all risk factors for lymph node metastasis. The comparison between second opinion and first pathological report revealed that lymphovascular invasion and tumor grading showed a lower level of concordance than other parameters. Our results demonstrated that second opinion modified risk assessment in about 10% of cases. It was mainly due to a lack in reporting of some parameters at the first diagnosis and a different evaluation in second opinion for updated guidelines. Considering the subgroup of patients with modified risk assessment, clinical data revealed that tumors, re-classified as low risk, did not develop lymph node metastasis that, conversely, occurred in patients identified as high risk by second opinion. In conclusion, second opinion significantly alters risk perception of endoscopically removed early colorectal carcinomas representing a valuable tool for their appropriate clinical management.
Keywords
Colorectal carcinoma, Prognostic factors, Second opinion, Early colorectal carcinoma, Lymph node metastasis, RISK-FACTORS, GUIDELINES

Citation

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MLA
Rampioni Vinciguerra, Gian Luca, et al. “Pathologist Second Opinion Significantly Alters Clinical Management of PT1 Endoscopically Resected Colorectal Cancer.” VIRCHOWS ARCHIV, vol. 475, no. 5, 2019, pp. 665–68.
APA
Rampioni Vinciguerra, G. L., Antonelli, G., Citron, F., Berardi, G., Angeletti, S., Baldassarre, G., … Pilozzi, E. (2019). Pathologist second opinion significantly alters clinical management of pT1 endoscopically resected colorectal cancer. VIRCHOWS ARCHIV, 475(5), 665–668.
Chicago author-date
Rampioni Vinciguerra, Gian Luca, Giulio Antonelli, Francesca Citron, Giammauro Berardi, Stefano Angeletti, Gustavo Baldassarre, Andrea Vecchione, Emilio Di Giulio, and Emanuela Pilozzi. 2019. “Pathologist Second Opinion Significantly Alters Clinical Management of PT1 Endoscopically Resected Colorectal Cancer.” VIRCHOWS ARCHIV 475 (5): 665–68.
Chicago author-date (all authors)
Rampioni Vinciguerra, Gian Luca, Giulio Antonelli, Francesca Citron, Giammauro Berardi, Stefano Angeletti, Gustavo Baldassarre, Andrea Vecchione, Emilio Di Giulio, and Emanuela Pilozzi. 2019. “Pathologist Second Opinion Significantly Alters Clinical Management of PT1 Endoscopically Resected Colorectal Cancer.” VIRCHOWS ARCHIV 475 (5): 665–668.
Vancouver
1.
Rampioni Vinciguerra GL, Antonelli G, Citron F, Berardi G, Angeletti S, Baldassarre G, et al. Pathologist second opinion significantly alters clinical management of pT1 endoscopically resected colorectal cancer. VIRCHOWS ARCHIV. 2019;475(5):665–8.
IEEE
[1]
G. L. Rampioni Vinciguerra et al., “Pathologist second opinion significantly alters clinical management of pT1 endoscopically resected colorectal cancer,” VIRCHOWS ARCHIV, vol. 475, no. 5, pp. 665–668, 2019.
@article{8634992,
  abstract     = {We retrospectively collected a series of 82 endoscopically removed early colorectal cancers. Histological specimens were revised by two gastrointestinal pathologists, performing a re-evaluation of all risk factors for lymph node metastasis. The comparison between second opinion and first pathological report revealed that lymphovascular invasion and tumor grading showed a lower level of concordance than other parameters. Our results demonstrated that second opinion modified risk assessment in about 10% of cases. It was mainly due to a lack in reporting of some parameters at the first diagnosis and a different evaluation in second opinion for updated guidelines. Considering the subgroup of patients with modified risk assessment, clinical data revealed that tumors, re-classified as low risk, did not develop lymph node metastasis that, conversely, occurred in patients identified as high risk by second opinion. In conclusion, second opinion significantly alters risk perception of endoscopically removed early colorectal carcinomas representing a valuable tool for their appropriate clinical management.},
  author       = {Rampioni Vinciguerra, Gian Luca and Antonelli, Giulio and Citron, Francesca and Berardi, Giammauro and Angeletti, Stefano and Baldassarre, Gustavo and Vecchione, Andrea and Di Giulio, Emilio and Pilozzi, Emanuela},
  issn         = {0945-6317},
  journal      = {VIRCHOWS ARCHIV},
  keywords     = {Colorectal carcinoma,Prognostic factors,Second opinion,Early colorectal carcinoma,Lymph node metastasis,RISK-FACTORS,GUIDELINES},
  language     = {eng},
  number       = {5},
  pages        = {665--668},
  title        = {Pathologist second opinion significantly alters clinical management of pT1 endoscopically resected colorectal cancer},
  url          = {http://dx.doi.org/10.1007/s00428-019-02603-y},
  volume       = {475},
  year         = {2019},
}

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