BACKGROUND: The aim of the study is to assess the influence of standardized protocol implementation on the quality of colorectal cancer histopathology reporting. METHODS: A standardized protocol was created based on the recommendations of The College of American Pathologists. The impact of this protocol was measured by comparing frequencies of assessed parameters in histopathology reports before and after implementation. RESULTS: In total, 177 histopathology reports were included in this study. The numbers of harvested lymph nodes were 12.4 ± 5.2 (colon) and 12.6 ± 5.4 (rectum) before protocol; and 17.1 ± 6.5 (colon), and 16.6 ± 7.0 after protocol implementation; differences were statistically significant. The recommended minimum of 12 lymph nodes was not achieved in 42.8 % (colon) and 45.7 % (rectum) of specimens before, and in 10.4 % (colon) and 17.7 % (rectum) of specimens after protocol implementation; differences were statistically significant. There were no differences in histopathology assessment of proximal and distal resection margins, grading assessment, TNM staging recording, and number of positive findings of microscopic tumor aggressiveness. The findings of tumor budding, tumor satellites, and assessment of microscopic tumor aggressiveness were more frequent after protocol implementation. Histopathology reports of rectal specimens contained assessments of the macroscopic quality of mesorectum, circumferential resection margin, and neoadjuvant therapy effect (if administered) only after protocol introduction. CONCLUSIONS: A standardized protocol is a valuable and effective tool for improving the quality of histopathology reporting. Its implementation is associated with more precise specimen evaluation, higher numbers of harvested lymph nodes, and improved completeness of histopathology reports.

Department of Surgical Studies Faculty of Medicine University of Ostrava Syllabova 19 Zábřeh 703 00 Ostrava Czech Republic

Zobrazit více v PubMed

Eur J Cancer. 2005 Sep;41(14):2071-8 PubMed

Surg Endosc. 2007 Dec;21(12):2142-6 PubMed

Eur J Surg Oncol. 2006 Mar;32(2):168-73 PubMed

J Natl Cancer Inst. 2005 Feb 2;97(3):219-25 PubMed

J Clin Oncol. 2008 Jan 10;26(2):303-12 PubMed

Rozhl Chir. 2013 May;92(5):250-4 PubMed

J Clin Pathol. 1997 Feb;50(2):138-42 PubMed

Colorectal Dis. 2011 Mar;13(3):e33-6 PubMed

J Am Coll Surg. 2008 Dec;207(6):882-7 PubMed

J Gastrointest Surg. 2002 Nov-Dec;6(6):883-88; discussion 889-90 PubMed

Eur J Cancer. 2005 Jan;41(2):272-9 PubMed

J Natl Cancer Inst. 2007 Mar 21;99(6):433-41 PubMed

Colorectal Dis. 2003 Nov;5(6):558-62 PubMed

Surg Oncol. 2011 Dec;20(4):e149-55 PubMed

Ann Surg. 2009 Jun;249(6):965-72 PubMed

Rozhl Chir. 2013 Jun;92(6):297-303 PubMed

Arch Pathol Lab Med. 2009 Oct;133(10):1539-51 PubMed

Cancer. 2004 Sep 1;101(5):1065-71 PubMed

Clin Transl Oncol. 2010 Jun;12(6):431-6 PubMed

Br J Surg. 2002 Mar;89(3):327-34 PubMed

Arch Pathol Lab Med. 2009 May;133(5):781-6 PubMed

N Engl J Med. 1985 Jun 20;312(25):1604-8 PubMed

Am J Surg Pathol. 2002 Feb;26(2):179-89 PubMed

Diverting ileostomy in laparoscopic rectal cancer surgery: high price of protection