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

Demetter, Pieter; Jouret‐Mourin, Anne; Silversmit, Geert; Vandendael, T.; Sempoux, Christine; Hoorens, Anne; Nagy, Nathalie; Cuvelier, Claude; Damme, Nancy Van; Penninckx, Freddy

doi:10.1111/codi.13254

Cited by 6 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, there was no central pathology review. The PROCARE study compared the quality of TME specimens as assessed by a central review panel and local pathologists for more than 250 patients with rectal cancer and found no major discrepancies, whereas the prediction of clinical outcomes was comparable. Hence, under the prerequisite of adequate pathologist training, a central review may not have led to a significant correction of individual pathology reports .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Plane of Total Mesorectal Excision With Prognosis of Rectal Cancer

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Hence, under the prerequisite of adequate pathologist training, a central review may not have led to a significant correction of individual pathology reports. 28,33 Second, baseline MRI results…”

Section: Limitationsmentioning

confidence: 99%

Association of Plane of Total Mesorectal Excision With Prognosis of Rectal Cancer

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The specific biological mechanism determining the association between NCM excision and CSS, but not LR or other cancer outcomes, is not easily explained, but reflects the variable and sometimes conflicting associations between mesorectal grading and cancer outcomes in the literature. In particular, there is conflicting evidence on the relationship between mesorectal grading and OS , OR rate and DR rate , and at least two series have indicated no significant association between mesorectal grading and cancer outcomes . Such wide discrepancy is likely to originate in the heterogeneity of study designs, variable sample sizes and reported lengths of follow‐up, which prompted our interest in conducting the present analysis.…”

Section: Discussionmentioning

confidence: 98%

The relationship between mesorectal grading and oncological outcome in rectal adenocarcinoma

et al. 2019

View full text Add to dashboard Cite

Aim The prognostic association between mesorectal grading and oncological outcome in patients undergoing resection for rectal adenocarcinoma is controversial. The aim of this retrospective chart review was to determine the individual impact of mesorectal grading on rectal cancer outcomes. Method We compared oncological outcomes in patients with complete, near‐complete and incomplete mesorectum who underwent rectal excision with curative intent from 2009 to 2014 for Stage cI–III rectal adenocarcinoma. We also assessed the independent association of mesorectal grading and oncological outcome using multivariate models including other relevant variables. Results Out of 505 patients (339 men, median age of 60 years), 347 (69%) underwent a restorative procedure. There were 452 (89.5%), 33 (6.5%) and 20 (4%) patients with a complete, near‐complete and incomplete mesorectum, respectively. Local recurrence was seen in 2.4% (n = 12) patients after a mean follow‐up of 3.1 ± 1.7 years. Unadjusted 3‐year Kaplan–Meier analysis by mesorectal grade showed decreased rates of overall, disease‐free and cancer‐specific survival and increased rates of overall and distant recurrence with a near‐complete mesorectum, while local recurrence was increased in cases of an incomplete mesorectum (all P < 0.05). On multivariate analyses, a near‐complete mesorectum was independently associated with decreased cancer‐specific survival (hazard ratio 0.26, 95% CI 0.1–0.7; P = 0.007). There were no associations between mesorectal grading and overall survival, disease‐free survival, overall recurrence or distant recurrence (all P > 0.05). Conclusion Mesorectal grading is independently associated with oncological outcome. It provides unique information for optimizing surgical quality in rectal cancer.

show abstract

“…TME performance and TME grading has been demonstrated to be standardizable and easily taught. [18][19][20] Concerted efforts to further standardize TME documentation and grading across other hospitals and specialties will likely result in improvement in these quality measures. 17,21,22 A single-institution study by Garcia-Granero, et al evaluated formal implementation of a macroscopic TME evaluation protocol and found that rates of TME assessment improved from 55% to 99% over a 10-year span.…”

Section: Discussionmentioning

confidence: 99%

Uptake of Total Mesorectal Excision and Total Mesorectal Excision Grading for Rectal Cancer: A Statewide Study

Kanters

Cleary

Shawn

et al. 2020

Diseases of the Colon &Amp; Rectum

View full text Add to dashboard Cite

BACKGROUND:Total mesorectal excision is associated with decreased local recurrence and improved disease-free survival following rectal cancer resection. The extent to which total mesorectal excision has been adopted in the United States is unknown. OBJECTIVE:We sought to assess trends in total mesorectal excision performance and grading in Michigan hospitals. DESIGN:This is a retrospective cohort study from the Michigan Surgical Quality Collaborative. Trends in total mesorectal excision performance and grade assignment were analyzed using chisquare tests and linear regression. SETTINGS:Participating hospitals (initially 14 hospitals, now 38) abstracted medical records data for rectal cancer cases from 2007-2016. PATIENTS:Patients who underwent rectal cancer resection. MAIN OUTCOME MEASURE:The main outcome measures were surgeon-documented total mesorectal excision performance and pathologist-reported total mesorectal excision grade. RESULTS:Of 510 rectal cancer cases, 367 (72.0%) had surgeon-reported total mesorectal excision performance and 78 (15.3%) had pathologist-reported total mesorectal excision grade. Between-hospital variability in total mesorectal excision performance ranged from 0 to 97% and *

show abstract

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

Cited by 6 publications

References 18 publications

Association of Plane of Total Mesorectal Excision With Prognosis of Rectal Cancer

Association of Plane of Total Mesorectal Excision With Prognosis of Rectal Cancer

The relationship between mesorectal grading and oncological outcome in rectal adenocarcinoma

Uptake of Total Mesorectal Excision and Total Mesorectal Excision Grading for Rectal Cancer: A Statewide Study

Contact Info

Product

Resources

About