SPECIMEN EXAMINATION FOLLOWING SURGERY FOR RECTAL CANCER: OUR TECHNIQUE
Abstract
Standard surgical treatment for rectal cancer is a total mesorectumectomy (TME) and it demands performing proper pathohistological examination of the removed specimen to select patients with high risk of local recurrence development and those indicated for adjuvant therapy. Pathologists should value quality of surgical intervention, examine both distal and circular resection margins (surgically mobilized mesorectal surface), define surgical clearance (distance from the circular resection margine to the tumor itself), perform pathological staging ((у)pTpN), determine histological type and stage of tumor differentiation. In this paper we describe a route of the specimen removed after the surgery for rectal cancer and its pathohistological examination technique which is based on the guidances of the British Royal Society of Pathologists specialized to the Regional Clinic Hospital requirements.
About the Authors
O. N. Ponkina
State Public Health Budget Institution 'Scientific Research Institute - Ochapovsky Regional Clinic Hospital # 1, Public Health Ministry of Krasnodar Region
Russian Federation
Russian Federation
V. V. Polovinkin
State Public Health Budget Institution 'Scientific Research Institute - Ochapovsky Regional Clinic Hospital # 1, Public Health Ministry of Krasnodar Region
Russian Federation
Russian Federation
References
1. Heald R.J., Husband E.M., Ryall R.D. The mesorectum in rectal cancer surgery - the clue to pelvic recurrence? // Br. J. Surg. Vol. 69 (1982) P. 613 - 616.
2. Quirk P., Williams G.T. Minimum dataset for colorectal cancer histopathology reports. Royal College of Pathologist 2000. (www.rcpath.org).
3. Quirk P. Effect of the plane of surgery on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial // Lancet 2009; 373: 821 - 28.
4. Hermanek P., Mansmann U., Staimmer D., et al. The German experience: the surgeon as a prognostic factor in colon and rectal cancer surgery // Surg Oncol Clin North Am. - 2000. - Vol. 9. - P. 33 - 49.
5. Nagtegaal ID., van Krieken JH. The role of pathologists in the quality control of diagnosis and treatment of rectal cancer - an overview // Eur J Cancer. - 2002. - 38(7). - P. 964 - 72.
6. Maslekar S., Sharma A., MacDonald A. et al. Mesorectal grades predict recurrences after curative resection for rectal cancer // Cancer Colon end Rectum. -2007. - Vol. 50. - № 1. - Р. 168 - 175.
7. Quirke P., Durdey P., Dixon MF., Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision // Lancet. -1986. - 2(8514). - P. 996 - 9.
8. Adam I., Mohamdee M., Martin I. Role of circumferential margin involvement in the local recurrence of rectal cancer // Lancet. - 1994. - 344. -P. 707 - 11.
9. Wibe A., Rendedal P.R., Svensson E. et al. Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer // Br. J. Surg. - 2002. - Vol. 89. - P. 327 - 334.
10. Nagtegaal I.D., Marijnen C.A., Kranenbarg E.K., van de Velde CJ. Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit // Am J Surg Pathol. - 2002. - 26(3). - P. 350 - 7.
11. Nagtegaal I.D., Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? // J Clin Oncol. - 2008. - 26. - P. 303 - 12.
12. Собин Л.Х., Госпадарович М.К., Виттекинд К. TNM Классификация злокачественых опухолей (7-е издание) // М.: Логосфера, 2011 - С. 275
13. Gooiker G.E.A., Kolfschoten N.T., Bastiannet E., Van De Velde C., Rosendaal F.R., Tollenaar R.A.E.V., Wouters M.W.J., Behalf O.N. Evaluating the validity of quality indicators for colorectal cancer care // J. Surg Oncol. - 2013. - 108. - P.465 - 571.
14. Tang L.H., Branton P., Burgart L.J., Carter D.K., Fitzgibbons P., Frankel W. L., Halling K.C., Jessup J., Kakar S., Minsky B., Nakhleh R., Washington K., Compton C.C. Protocol for the Examination of Specimens From Patients With Primary Carcinoma of the Colon and Rectum. College of American Pathologist 2016 (www.CAP.org).
15. Ryan R., Gibbons D., Hyland J.M.P., et al. Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal cancer. Histopathology. 2005; 47(2): 141 - 146. 30.
Review
For citations:
Ponkina O.N., Polovinkin V.V. SPECIMEN EXAMINATION FOLLOWING SURGERY FOR RECTAL CANCER: OUR TECHNIQUE. Innovative Medicine of Kuban. 2016;(4):23-29. (In Russ.)
Views:
764
Email this article 
