Quality and completeness of histopathology reports of rectal cancer resections. Results of an audit in Brittany.
Few data are available in France about implementation of guidelines for pathology reports of rectal cancer resections.


OBJECTIVE
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.


CONCLUSIONS
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.
Direction Régionale du Service Médical de Rennes, Hôpital Pontchaillou, Rennes. yannick.eon@ersm-bretagne.cnamts.fr
Yannick
Y
Eon
Jean-Yves
JY
Le Douy
Bernard
B
Lamer
Jean
J
Battini
Jean-François
JF
Bretagne
D000368:Aged; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008485:Medical Audit; D008499:Medical Records / Q000592:standards*; D010338:Pathology, Clinical / Q000592:standards*; D011446:Prospective Studies; D011786:Quality Control; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery