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. 2007 Aug;20(3):158-66.
doi: 10.1055/s-2007-984860.

The pathologist's role in rectal cancer patient assessments

Joseph E Willis  1
Affiliations

The pathologist's role in rectal cancer patient assessments

Joseph E Willis. Clin Colon Rectal Surg. 2007 Aug.

Abstract

Since Cuthbert Dukes fundamental work linking cancer stage to prognosis, the pathologist has had an ever-expanding role in the multidisciplinary management of rectal cancer. Gross dissection techniques and histologic evaluation are reviewed. The evolving tumor size, node status, metastasis classification (TNM) staging system is outlined. The pathologist's critical role in correctly assessing circumferential margins and establishing resection adequacy and staging accuracy via lymph node assessment is emphasized.

Keywords: Rectal cancer; metastasis (TNM) classification; node status; pathological evaluation; total mesorectal excision; tumor size.

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Figures

Figure 1
Figure 1
Smooth outer surface of a total mesorectal excision.
Figure 2
Figure 2
Total mesorectal excision with ulcer crater at site of irradiated rectal cancer (short arrows), “donut section” at distal margin (long arrows).
Figure 3
Figure 3
Moderately differentiated adenocarcinoma with characteristic luminal necrosis (H&E × 20).
Figure 4
Figure 4
Pathological regression. Small amounts of residual carcinoma (arrows and inset) in a background of extensive fibrosis (H&E × 4, Inset × 20).
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