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Completeness of pathology reports in stage II colorectal cancer

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posted on 24.01.2017 by Stefan Büttner, Zarina S. Lalmahomed, Robert R. J. Coebergh van den Braak, Bettina E. Hansen, Peter Paul L. O. Coene, Jan Willem T. Dekker, David D. E. Zimmerman, Geert W. M. Tetteroo, Wouter J. Vles, Wietske W. Vrijland, Ruth E. M. Fleischeuer, Anneke A. M. van der Wurff, Mike Kliffen, Rolf Torenbeek, J. H. Carel Meijers, Michael Doukas, Jan N. M. IJzermans

Introduction: The completeness of the pathological examination of resected colon cancer specimens is important for further clinical management. We reviewed the pathological reports of 356 patients regarding the five factors (pT-stage, tumor differentiation grade, lymphovascular invasion, tumor perforation and lymph node metastasis status) that are used to identify high-risk stage II colon cancers, as well as their impact on overall survival (OS).

Methods: All patients with stage II colon cancer who were included in the first five years of the MATCH study (1 July 2007 to 1 July 2012) were selected (n = 356). The hazard ratios of relevant risk factors were calculated using Cox Proportional Hazards analyses.

Results: In as many as 69.1% of the pathology reports, the desired information on one or more risk factors was considered incomplete. In multivariable analysis, age (HR: 1.07, 95%CI 1.04–1.10, p < .001), moderately- (HR: 0.35, 95%CI 0.18–0.70, p = .003) and well (HR 0.11, 95%CI 0.01–0.89, p = .038) differentiated tumors were significantly associated with OS.

Conclusions: Pathology reports should better describe the five high-risk factors, in order to enable proper patient selection for further treatment. Chemotherapy may be offered to stage II patients only in select instances, yet a definitive indication is still unavailable.

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