A retrospective review of 325 patients was undertaken to analyse whether involvement of the radial resection margin (RRM) could predict locally recurrent disease or distant metastases in patients who had curative surgery for rectal or rectosigmoid cancer. Information on the RRM was available in 253 patients. The RRM was involved in 31 (12 per cent). Nine of these 31 patients developed local recurrence (29 per cent), while only 17 local recurrences were diagnosed in 217 patients (8 per cent) without involvement of the RRM (P < 0.01). At 2 years the overall local recurrence rate was 10 per cent. Distant metastases were diagnosed in 46 patients (18 per cent) and RRM involvement was identified as a prognostic factor depending on lymph node involvement (N stage) (P = 0.02). Local recurrence and some distant metastases result from microscopically incomplete resection. Assessment of the radial depth of tumour invasion by careful histological examination of x791p4ecimen may be used for selection of patients for adjuvant radiotherapy and/or chemotherapy.
SummaryThe quality of cancer registry data is of great importance to the usefulness of a cancer registry. To investigate the quality of its data the IKL cancer registry (Integraal Kankercentrum Limburg) performed a study with the aim of comparing data supplied by clinicians with data collected by registration personnel.Twenty clinicians reabstracted the information of a random sample of about ten of their patients, who were diagnosed with cancer in 1989 or 1990. After coding, the information was compared with the contents of the cancer registry records.For comparison of agreement the information of 190 cases was available. The relative frequency of major disagreements was 0% for date of birth, 0% for gender, 5% for date of incidence, 6% for primary site, 2% for laterality, 2% for histologic type and 2% for behaviour code.In The clinician was asked to fill in a cancer registry form, that was developed especially for this study, for each of his patients. The form was accompanied by a comprehensive explanation. The collected items were date of birth, gender, date of incidence, primary site (to be completed in free text), laterality, histologic type (free text) and behaviour code (in free text).The returned forms were coded by one of the senior staff members of the cancer registry. The coded forms were returned to the clinician and only after approval were the codes compared with the original information in the cancer registry. Differences were divided into minor and major disagreements according to an adapted proposal from a reabstracting study (CCPDS, 1985) and are summarised in Table I. For histologic type the ICD-O codes were merged into clinically and epidemiologically relevant groups (Berg, 1982).
ResultsThe twenty clinicians completed 190 cancer registry forms. For one clinician only eight eligible patients (instead of ten) could be selected. Two of the clinicians returned only 12 out of 24 forms in time. All the coded information of the forms was approved by the clinicians. In Table II the results of the comparison of the clinicians' data with the original cancer registry data are presented.No disagreements were detected in date of birth and gender. With respect to data of incidence ten cases (5%)
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