Évaluation nationale multicentrique des comptes rendus anatomopathologiques des cancers du rectum en France en 2016

Abstract : The quality of pathologic assessment of rectal cancer specimen is crucial to treatment efficiency and patient survival. The Royal College of Pathologists (RCP) recommended evaluating the quality of pathology report in routine practice using 3 indicators, the number of lymph nodes (LN) analyzed, the rate of venous invasion (VI) and peritoneal involvement (pT4a). The aim of this study was (1) to evaluate the 3 quality indicators of the French national pathology reports compared with the British guidelines and, (2) to assess the influence of neoadjuvant radiochemotherapy on them. From January 1 to December 31, 2016 all pathology reports for rectal adenocarcinoma were collected from French voluntary departments. Neoadjuvant radiochemotherapy included long course radiotherapy with concomitant 5-FU-based chemotherapy. The standards recommended by the RCP were a median of LN analyzed ≥ 12, a rate of VI ≥ 30% and a rate of pT4a ≥ 10%. A total of 983 rectal cancer pathology reports were analyzed from 22 French pathology departments. The median of LN analyzed was 15 and the rate of centers having ≥ 12 LN was 81%. The rate of VI was 30% and the frequency of centers having ≥ 30% VI was 41%. The rate of pT4a was 4% and the rate of centers reporting ≥ 10% pT4a was 18%. None of the centers reached the threshold for the 3 quality indicators. All three indicators were lower after radiochemotherapy compared to surgery alone. In conclusion, in French routine practice the value of two of the three quality indicators (LN analyzed and VI) were globally in line with the RCP guidelines. However, the rate of pT4a was very low particularly after radiochemotherapy. This suggests that pT4a lacks interest in rectal cancer under peritoneal reflection.
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Master Thesis
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Camille Aymond Boutanos. Évaluation nationale multicentrique des comptes rendus anatomopathologiques des cancers du rectum en France en 2016. Médecine humaine et pathologie. 2018. ⟨dumas-02077020⟩

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