Quality and completeness of histopathology reports of rectal cancer resections. Results of an audit in Brittany

Abstract

Few data are available in France about implementation of guidelines for pathology reports of rectal cancer resections.

Aim: The purpose of this study was to audit quality and completeness of histopathology reports of rectal cancer resections in Brittany by comparing results with French guidelines published in 1998.

Methods: All inhabitants in Brittany who were beneficiaries of the general health insurance system and who underwent surgery for rectal cancer between February 1999 and January 2000 were included in the study. Twenty-one pathology laboratories, including 14 private laboratories, participated in this study. All pathology reports were examined by two physician-consultants of the health insurance system trained in the analysis of pathology reports (search for consigned or missing data). Results were compared with guidelines published in 1998.

Results: Of 234 pathology reports, 204 (84%) mentioned the number of examined lymph nodes and 217 (93%) the number of those found positive. The criterion of at least 8 examined lymph nodes was noted in 53.4% of reports. Longitudinal margin involvement was recorded in 92% of reports and circumferential margin involvement in 27% only. Venous and/or lymphatic and neural invasion were recorded in 34% and 18% of reports, respectively. Tumor staging was made by using UICC (pTNM) in 67% of reports.

Conclusion: This study shows that the quality and completeness of histopathology reports of rectal cancer resections could be improved in Brittany. Despite its documented value as an important predictor of local recurrence, circumferential margin involvement is too frequently omitted. Standardisation of the examination procedures and exhaustive reporting would be useful to improve practice quality.