Scoring the quality of total mesorectal excision for the prediction of cancer-specific outcome.
Details
Serval ID
serval:BIB_ECEE7F112154
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Scoring the quality of total mesorectal excision for the prediction of cancer-specific outcome.
Journal
Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Contributor(s)
PROCARE , Bertrand C., De Coninck D., Duinslaeger M., Kartheuser A., Penninckx F., Van de Stadt J., Vaneerdeweg W., Claeys D., Burnon D., Haustermans K., Scalliet P., Spaas P., Demetter P., Jouret-Mourin A., Sempoux C., Demey W., Humblet Y., Van Cutsem E., Laurent S., Van Cutsem E., Van Laethem J., Op de Beeck B., Smeets P., Melange M., Rahier J., Cabooter M., Pattyn P., Peeters M., Buset M., Mansvelt B., Vindevoghel K., Van Eycken E., Daubie M., Thijs A., Penninckx F.
ISSN
1463-1318 (Electronic)
ISSN-L
1462-8910
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
17
Number
5
Pages
O115-O122
Language
english
Notes
Publication types: 7">Clinical Study ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
AIM: A three-grade system for macroscopic evaluation of the resection plane is used to describe the quality of total mesorectal excision (TME). In several studies, two of the three grades have been combined when analysing the outcome. The aim of our study was to compare the predictive value of the three-graded with that of a two-graded TME score.
METHOD: The quality of TME in 1382 patients who underwent elective resection for mid or low rectal adenocarcinoma was registered by 65 hospitals in PROCARE, a Belgian multidisciplinary improvement project. Prediction of outcome based on the classic three-grade score was compared with a two-grade scoring system in which intramesorectal resection (IMR) was combined with mesorectal (MRR) or with muscularis propria resection (MPR). End-points included the local recurrence rate, distant metastasis rate (DMR), disease-free survival (DFS) and overall survival (OS).
RESULTS: Among the 1382 resections, 63% were MRR, 27% IMR and 9% MPR. No significant differences were found in local recurrence between the different grades of TME. A two-grade score distinguishing MRR from the others was found to predict DMR, DFS and OS as well as the three-grade score.
CONCLUSION: The discriminatory and predictive value of a two-grade score, differentiating MRR from the combined IMR and MPR, was as good as the classic three-grade score.
METHOD: The quality of TME in 1382 patients who underwent elective resection for mid or low rectal adenocarcinoma was registered by 65 hospitals in PROCARE, a Belgian multidisciplinary improvement project. Prediction of outcome based on the classic three-grade score was compared with a two-grade scoring system in which intramesorectal resection (IMR) was combined with mesorectal (MRR) or with muscularis propria resection (MPR). End-points included the local recurrence rate, distant metastasis rate (DMR), disease-free survival (DFS) and overall survival (OS).
RESULTS: Among the 1382 resections, 63% were MRR, 27% IMR and 9% MPR. No significant differences were found in local recurrence between the different grades of TME. A two-grade score distinguishing MRR from the others was found to predict DMR, DFS and OS as well as the three-grade score.
CONCLUSION: The discriminatory and predictive value of a two-grade score, differentiating MRR from the combined IMR and MPR, was as good as the classic three-grade score.
Keywords
Adenocarcinoma/epidemiology, Adenocarcinoma/pathology, Adult, Aged, Aged, 80 and over, Databases, Factual, Digestive System Surgical Procedures/standards, Disease-Free Survival, Elective Surgical Procedures, Female, Humans, Intestinal Mucosa, Male, Mesentery/pathology, Mesentery/surgery, Middle Aged, Neoplasm Metastasis, Neoplasm Recurrence, Local, Prospective Studies, Rectal Neoplasms/pathology, Rectal Neoplasms/surgery, Rectum/pathology, Rectum/surgery, Treatment Outcome, Young Adult
Pubmed
Web of science
Create date
20/10/2016 16:33
Last modification date
20/08/2019 17:14
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