Effect of pathologist's dedication on lymph node detection rate and postoperative survival in colorectal cancer
Aim As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph node metastases, the pathologist's dedication may have a considerable influence on postoperative survival. Method The aim of this retrospective study was to assess the impact of the pathologist's dedica...
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| Veröffentlicht in: | Colorectal disease 2018-07, Vol.20 (7), p.O173-O180 |
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| container_title | Colorectal disease |
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| creator | Unger, L. W. Muckenhuber, M. Riss, S. Argeny, S. Stift, J. Mesteri, I. Stift, A. |
| description | Aim
As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph node metastases, the pathologist's dedication may have a considerable influence on postoperative survival.
Method
The aim of this retrospective study was to assess the impact of the pathologist's dedication on lymph node detection rate and postoperative survival in patients operated on by a single experienced colorectal surgeon within a 5‐year period. We assessed 229 patients undergoing total mesorectal excision or complete mesocolic excision by the senior author between 1 January 2009 and 31 December 2013. Pathologists were grouped as ‘general pathologist’ or ‘dedicated pathologist’ depending on their dedication/specialization.
Results
Dedicated pathologists found statistically significantly more lymph nodes in colorectal specimens than general pathologists [23 (interquartile range 24) vs 14 (interquartile range 11), respectively; P < 0.001]. The detection rate of ≥ 12 lymph nodes per specimen was significantly higher in the dedicated pathologist group [65/74 (87.8%) vs 105/155 (67.7%); P = 0.016]. However, postoperative survival did not differ in the respective subgroups. In the multivariable analysis by Cox proportional hazard model, International Union against Cancer Stage IV was the only factor associated with decreased disease‐specific survival (hazard ratio 28.257; 95% CI 3.850–207.386; P = 0.001).
Conclusion
In our centre, the pathologist's dedication has an impact on lymph node detection rate but does not influence postoperative disease‐specific survival. |
| doi_str_mv | 10.1111/codi.14241 |
| format | Article |
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As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph node metastases, the pathologist's dedication may have a considerable influence on postoperative survival.
Method
The aim of this retrospective study was to assess the impact of the pathologist's dedication on lymph node detection rate and postoperative survival in patients operated on by a single experienced colorectal surgeon within a 5‐year period. We assessed 229 patients undergoing total mesorectal excision or complete mesocolic excision by the senior author between 1 January 2009 and 31 December 2013. Pathologists were grouped as ‘general pathologist’ or ‘dedicated pathologist’ depending on their dedication/specialization.
Results
Dedicated pathologists found statistically significantly more lymph nodes in colorectal specimens than general pathologists [23 (interquartile range 24) vs 14 (interquartile range 11), respectively; P < 0.001]. The detection rate of ≥ 12 lymph nodes per specimen was significantly higher in the dedicated pathologist group [65/74 (87.8%) vs 105/155 (67.7%); P = 0.016]. However, postoperative survival did not differ in the respective subgroups. In the multivariable analysis by Cox proportional hazard model, International Union against Cancer Stage IV was the only factor associated with decreased disease‐specific survival (hazard ratio 28.257; 95% CI 3.850–207.386; P = 0.001).
Conclusion
In our centre, the pathologist's dedication has an impact on lymph node detection rate but does not influence postoperative disease‐specific survival.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.14241</identifier><identifier>PMID: 29706021</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Biopsy ; Chemotherapy ; Colorectal cancer ; Colorectal carcinoma ; complete mesocolic excision ; Lymph nodes ; Lymphatic system ; Metastases ; pathology ; Specialization ; Statistical models ; Survival ; total mesorectal excision</subject><ispartof>Colorectal disease, 2018-07, Vol.20 (7), p.O173-O180</ispartof><rights>Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland</rights><rights>Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.</rights><rights>Copyright © 2018 The Association of Coloproctology of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3571-55a9f5fe1144ea36bd86f0f235a1d6c8f66d2af95f88ba074bb90d594c8a08b03</citedby><cites>FETCH-LOGICAL-c3571-55a9f5fe1144ea36bd86f0f235a1d6c8f66d2af95f88ba074bb90d594c8a08b03</cites><orcidid>0000-0002-8423-2268</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcodi.14241$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcodi.14241$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29706021$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Unger, L. W.</creatorcontrib><creatorcontrib>Muckenhuber, M.</creatorcontrib><creatorcontrib>Riss, S.</creatorcontrib><creatorcontrib>Argeny, S.</creatorcontrib><creatorcontrib>Stift, J.</creatorcontrib><creatorcontrib>Mesteri, I.</creatorcontrib><creatorcontrib>Stift, A.</creatorcontrib><title>Effect of pathologist's dedication on lymph node detection rate and postoperative survival in colorectal cancer</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim
As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph node metastases, the pathologist's dedication may have a considerable influence on postoperative survival.
Method
The aim of this retrospective study was to assess the impact of the pathologist's dedication on lymph node detection rate and postoperative survival in patients operated on by a single experienced colorectal surgeon within a 5‐year period. We assessed 229 patients undergoing total mesorectal excision or complete mesocolic excision by the senior author between 1 January 2009 and 31 December 2013. Pathologists were grouped as ‘general pathologist’ or ‘dedicated pathologist’ depending on their dedication/specialization.
Results
Dedicated pathologists found statistically significantly more lymph nodes in colorectal specimens than general pathologists [23 (interquartile range 24) vs 14 (interquartile range 11), respectively; P < 0.001]. The detection rate of ≥ 12 lymph nodes per specimen was significantly higher in the dedicated pathologist group [65/74 (87.8%) vs 105/155 (67.7%); P = 0.016]. However, postoperative survival did not differ in the respective subgroups. In the multivariable analysis by Cox proportional hazard model, International Union against Cancer Stage IV was the only factor associated with decreased disease‐specific survival (hazard ratio 28.257; 95% CI 3.850–207.386; P = 0.001).
Conclusion
In our centre, the pathologist's dedication has an impact on lymph node detection rate but does not influence postoperative disease‐specific survival.</description><subject>Biopsy</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>complete mesocolic excision</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Metastases</subject><subject>pathology</subject><subject>Specialization</subject><subject>Statistical models</subject><subject>Survival</subject><subject>total mesorectal excision</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kctOxCAUhonReN_4AIbEhcakIwdaSpdmHC-JyWx03VAuiumUCu2YeXsZR124kJDAge98IfwInQCZQBpXyms3gZzmsIX2IecsAwZi-2tPM1EB2UMHMb4RArwEsYv2aFUSTijsIz-z1qgBe4t7Obz61r-4OJxHrI12Sg7OdzjNdrXoX3HntUkXQ2pYnwc5GCw7jXsfB9-bVLulwXEMS7eULXYdVkkYEp4qJTtlwhHasbKN5vh7PUTPt7On6X32OL97mF4_ZooVJWRFIStbWAOQ50Yy3mjBLbGUFRI0V8Jyrqm0VWGFaCQp86apiC6qXAlJREPYIbrYePvg30cTh3rhojJtKzvjx1hTwmhZFUKwhJ79Qd_8GLr0ukRxWpaU5ZCoyw2lgo8xGFv3wS1kWNVA6nUM9TqG-iuGBJ9-K8dmYfQv-vPvCYAN8OFas_pHVU_nNw8b6ScDb5NY</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Unger, L. W.</creator><creator>Muckenhuber, M.</creator><creator>Riss, S.</creator><creator>Argeny, S.</creator><creator>Stift, J.</creator><creator>Mesteri, I.</creator><creator>Stift, A.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8423-2268</orcidid></search><sort><creationdate>201807</creationdate><title>Effect of pathologist's dedication on lymph node detection rate and postoperative survival in colorectal cancer</title><author>Unger, L. W. ; Muckenhuber, M. ; Riss, S. ; Argeny, S. ; Stift, J. ; Mesteri, I. ; Stift, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3571-55a9f5fe1144ea36bd86f0f235a1d6c8f66d2af95f88ba074bb90d594c8a08b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Biopsy</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>complete mesocolic excision</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Metastases</topic><topic>pathology</topic><topic>Specialization</topic><topic>Statistical models</topic><topic>Survival</topic><topic>total mesorectal excision</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Unger, L. W.</creatorcontrib><creatorcontrib>Muckenhuber, M.</creatorcontrib><creatorcontrib>Riss, S.</creatorcontrib><creatorcontrib>Argeny, S.</creatorcontrib><creatorcontrib>Stift, J.</creatorcontrib><creatorcontrib>Mesteri, I.</creatorcontrib><creatorcontrib>Stift, A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Unger, L. W.</au><au>Muckenhuber, M.</au><au>Riss, S.</au><au>Argeny, S.</au><au>Stift, J.</au><au>Mesteri, I.</au><au>Stift, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of pathologist's dedication on lymph node detection rate and postoperative survival in colorectal cancer</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2018-07</date><risdate>2018</risdate><volume>20</volume><issue>7</issue><spage>O173</spage><epage>O180</epage><pages>O173-O180</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim
As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph node metastases, the pathologist's dedication may have a considerable influence on postoperative survival.
Method
The aim of this retrospective study was to assess the impact of the pathologist's dedication on lymph node detection rate and postoperative survival in patients operated on by a single experienced colorectal surgeon within a 5‐year period. We assessed 229 patients undergoing total mesorectal excision or complete mesocolic excision by the senior author between 1 January 2009 and 31 December 2013. Pathologists were grouped as ‘general pathologist’ or ‘dedicated pathologist’ depending on their dedication/specialization.
Results
Dedicated pathologists found statistically significantly more lymph nodes in colorectal specimens than general pathologists [23 (interquartile range 24) vs 14 (interquartile range 11), respectively; P < 0.001]. The detection rate of ≥ 12 lymph nodes per specimen was significantly higher in the dedicated pathologist group [65/74 (87.8%) vs 105/155 (67.7%); P = 0.016]. However, postoperative survival did not differ in the respective subgroups. In the multivariable analysis by Cox proportional hazard model, International Union against Cancer Stage IV was the only factor associated with decreased disease‐specific survival (hazard ratio 28.257; 95% CI 3.850–207.386; P = 0.001).
Conclusion
In our centre, the pathologist's dedication has an impact on lymph node detection rate but does not influence postoperative disease‐specific survival.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29706021</pmid><doi>10.1111/codi.14241</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8423-2268</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Biopsy Chemotherapy Colorectal cancer Colorectal carcinoma complete mesocolic excision Lymph nodes Lymphatic system Metastases pathology Specialization Statistical models Survival total mesorectal excision |
| title | Effect of pathologist's dedication on lymph node detection rate and postoperative survival in colorectal cancer |
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