Assessment of extent and completeness of mesorectal excision for rectal cancer by histopathology and MRI

IF 0.3 Q4 ONCOLOGY
T. Hassan, F. Parray, Zubaida Rasool, N. Chowdri, F. Shaheen, R. Wani
{"title":"Assessment of extent and completeness of mesorectal excision for rectal cancer by histopathology and MRI","authors":"T. Hassan, F. Parray, Zubaida Rasool, N. Chowdri, F. Shaheen, R. Wani","doi":"10.1097/IJ9.0000000000000053","DOIUrl":null,"url":null,"abstract":"Introduction: High quality of total mesorectal excision (TME) surgical technique and critical feedback regarding its completeness by pathologist and a radiologist has been shown to influence the quality of surgery in patients with rectal cancer. In this study, we tried to audit the quality of TME by 2 independent observers, a consultant pathologist and radiologist. TME was performed for all patients with rectal tumors located <12 cm from the anal verge. Main Outcome Measures: TME specimens were examined for completeness by experienced single consultant pathologist to avoid interobserver bias. Postoperatively magnetic resonance imaging was done that was interpreted by a single consultant radiologist to avoid interobserver bias in the study. Discussion: Of total 103 patients, TME assessment was done in 53 patients. TME was complete in 35 cases (66%), near complete in 14 cases (26%), and incomplete in 4 cases (8%) (P<0.05). Twenty-eight cases were subjected to radiologic assessment of TME. Complete TME was found in 19 (67%) and residual mesorectum was found in 9 (32%). The radiologic findings co-related with pathology findings in these 28 cases as 17 cases were confirmed TME complete by both magnetic resonance imaging and histopathology, 4 cases were confirmed incomplete by both and out of 7 near complete TME by pathology, 2 were labeled as complete on radiology while 5 were labeled as incomplete (P<0.05). Seven (13.2%) cases had positive circumferential resection margin. Distal resection margin was >2 cm in about 81.1%, <2 cm in 15% and involved in 3.7% of cases. The lymph node yield was of 4–21 with an average of 11.5 nodes; with 54.7% having adequate nodal harvest (>12 lymph nodes). Conclusions: Pathologist’s and radiologist’s constructive criticism will always help a surgeon to improve his quality of TME.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"6 1","pages":"e53"},"PeriodicalIF":0.3000,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Surgery-Oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/IJ9.0000000000000053","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 1

Abstract

Introduction: High quality of total mesorectal excision (TME) surgical technique and critical feedback regarding its completeness by pathologist and a radiologist has been shown to influence the quality of surgery in patients with rectal cancer. In this study, we tried to audit the quality of TME by 2 independent observers, a consultant pathologist and radiologist. TME was performed for all patients with rectal tumors located <12 cm from the anal verge. Main Outcome Measures: TME specimens were examined for completeness by experienced single consultant pathologist to avoid interobserver bias. Postoperatively magnetic resonance imaging was done that was interpreted by a single consultant radiologist to avoid interobserver bias in the study. Discussion: Of total 103 patients, TME assessment was done in 53 patients. TME was complete in 35 cases (66%), near complete in 14 cases (26%), and incomplete in 4 cases (8%) (P<0.05). Twenty-eight cases were subjected to radiologic assessment of TME. Complete TME was found in 19 (67%) and residual mesorectum was found in 9 (32%). The radiologic findings co-related with pathology findings in these 28 cases as 17 cases were confirmed TME complete by both magnetic resonance imaging and histopathology, 4 cases were confirmed incomplete by both and out of 7 near complete TME by pathology, 2 were labeled as complete on radiology while 5 were labeled as incomplete (P<0.05). Seven (13.2%) cases had positive circumferential resection margin. Distal resection margin was >2 cm in about 81.1%, <2 cm in 15% and involved in 3.7% of cases. The lymph node yield was of 4–21 with an average of 11.5 nodes; with 54.7% having adequate nodal harvest (>12 lymph nodes). Conclusions: Pathologist’s and radiologist’s constructive criticism will always help a surgeon to improve his quality of TME.
用组织病理学和MRI评估直肠癌肠系膜切除的程度和完整性
导读:高质量的全肠系膜切除(TME)手术技术和病理学家和放射科医生对其完整性的关键反馈已被证明影响直肠癌患者的手术质量。在这项研究中,我们试图通过2个独立的观察员,一个咨询病理学家和放射科医生来审核TME的质量。所有直肠肿瘤位于2cm(约81.1%,12个淋巴结)的患者均行TME。结论:病理和放射科医师的建设性批评有助于外科医生提高TME手术质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
8
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信