دورية أكاديمية
أعرض في EDS

Reproducibility of AJCC Criteria for Classifying Deeply Invasive Colon Cancers Is Suboptimal for Consistent Cancer Staging.

التفاصيل البيبلوغرافية
العنوان: Reproducibility of AJCC Criteria for Classifying Deeply Invasive Colon Cancers Is Suboptimal for Consistent Cancer Staging.
المؤلفون: Panarelli NC; Albert Einstein College of Medicine, Bronx, NY., Hammer STG; University of Texas Southwestern Medical Center, Dallas, TX., Lin J; Indiana University School of Medicine, Indianapolis, IN., Gopal P; University of Texas Southwestern Medical Center, Dallas, TX., Nalbantoglu I; Yale University School of Medicine, New Haven, CT., Zhou L; University of Michigan Medical School, Ann Arbor, MI., Cheng J; University of Michigan Medical School, Ann Arbor, MI., Gersten AJ; Albert Einstein College of Medicine, Bronx, NY., McHugh JB; University of Michigan Medical School, Ann Arbor, MI., Parkash V; Yale University School of Medicine, New Haven, CT., Lucas E; University of Texas Southwestern Medical Center, Dallas, TX., Westerhoff M; University of Michigan Medical School, Ann Arbor, MI.
المصدر: The American journal of surgical pathology [Am J Surg Pathol] 2020 Oct; Vol. 44 (10), pp. 1381-1388.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 7707904 Publication Model: Print Cited Medium: Internet ISSN: 1532-0979 (Electronic) Linking ISSN: 01475185 NLM ISO Abbreviation: Am J Surg Pathol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2015- > : Philadelphia, PA : Wolters Kluwer Health, Inc.
Original Publication: New York, Masson.
مواضيع طبية MeSH: Adenocarcinoma/*pathology , Colonic Neoplasms/*pathology , Neoplasm Staging/*methods, Adenocarcinoma/classification ; Adult ; Aged ; Aged, 80 and over ; Colonic Neoplasms/classification ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging/standards ; Observer Variation ; Young Adult
مستخلص: The eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual attempts to address ambiguity in the pT category assignment for colon cancer from prior editions. Despite modifications, the distinction between the pT3 and pT4a categories continues to be a source of diagnostic confusion. In this study, we assessed interobserver agreement among pathologists from different institutions in the application of AJCC eighth edition criteria for categorizing deeply invasive colonic adenocarcinomas. We identified morphologic patterns that produce diagnostic confusion. We assessed 47 colon cancers that closely approached the serosal surface. Six pathologists with interest in gastrointestinal pathology and 4 focused in other subspecialties classified each case as pT3 or pT4a, based on examination of low-magnification and high-magnification images of the most deeply invasive area. Interobserver agreement was assessed using Fleiss' κ. Cases displayed 3 morphologic patterns at the advancing tumor edge, namely, (1) continuous invasion through an inflammatory focus, (2) pushing border, and (3) infiltrative glands and cell clusters with serosal reaction. Gastrointestinal pathologists achieved slight (κ=0.21) or moderate (κ=0.46) and (κ=0.51) agreement in each category, whereas agreement among nongastrointestinal pathologist was fair (0.31) and (0.39), or moderate (0.57) for each category, respectively. In 10 (21%) cases, the distinction between pT3 and pT4a would have changed the overall clinical stage. We conclude that histologic criteria for serosal penetration is a persistent source of diagnostic ambiguity for gastrointestinal and general pathologists in the pT categorization of colon cancers. Clarification of these criteria will help ensure uniform reporting of pathologic and clinical stage.
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تواريخ الأحداث: Date Created: 20200915 Date Completed: 20201127 Latest Revision: 20210131
رمز التحديث: 20240829
DOI: 10.1097/PAS.0000000000001510
PMID: 32931163
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-0979
DOI:10.1097/PAS.0000000000001510