Endoscopy 2020; 52(S 01): S44
DOI: 10.1055/s-0040-1704135
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 10:30 – 12:00 Innocent & guilty polyps Wicklow Meeting Room 3
© Georg Thieme Verlag KG Stuttgart · New York

QUALITY OF PATHOLOGY REPORT AND ADHERENCE TO GUIDELINES IN A FRENCH MULTICENTER COHORT OF T1 COLORECTAL CANCER TREATED BY ENDOSCOPIC RESECTION

F Corre
1   Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Gastroenterology, Paris, France
,
M Barret
1   Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Gastroenterology, Paris, France
,
JP Ratone
2   Paoli Calmettes Institute, Gastroenterology, Marseille, France
,
J Albouys
3   Limoges University Hospital, Gastroenterology, Limoges, France
,
G Rahmi
4   Georges Pompidou University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Gastroenterology, Paris, France
,
E Chabrun
5   Haut-Lévêque University Hospital, Gastroenterology, Bordeaux, France
,
JM Canard
6   Trocadero Clinic, Gastroenterology, Paris, France
,
M Camus
7   Saint-Antoine University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Gastroenterology, Paris, France
,
T Wallenhorst
8   Rennes University Hospital, Gastroenterology, Rennes, France
,
D Karsenti
9   Bercy Clinic, Gastroenterology, Paris, France
,
M François
10   Nancy University Hospital, Gastroenterology, Nancy, France
,
R Gerard
11   Lille University Hospital, Gastroenterology, Lille, France
,
J Jacques
3   Limoges University Hospital, Gastroenterology, Limoges, France
,
B Terris
12   Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Pathology, Paris, France
,
R Coriat
1   Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Gastroenterology, Paris, France
,
S Chaussade
1   Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Gastroenterology, Paris, France
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims According to the Japanese (JSCCR) and European (ESGE) guidelines, the presence of deep submucosal infiltration (> 1000µm), poor tumor differentiation, lympho-vascular invasion, or grade 2-3 tumor budding on a T1 colorectal carcinoma (T1CRC) endoscopically resected should lead to additional surgery with lymph node dissection. The aim of this study was to evaluate practices in France concerning the quality of the pathology report (PR) and the adherence to guidelines in endoscopic treatment for T1CRC.

Methods We conducted a retrospective study including all patients with endoscopic resection for T1CRC performed in eight French expert centers between March 2012 and July 2019. We collected demographic, clinical, endoscopic and histological data.

Results 223 patients were included. The mean age of the population was 70.9±10.9 years. Concerning the quality of PR, R0 or R1 vertical margin was indicated in 100% of cases; depth of submucosal invasion was missing in 6 (2.7%) PR; tumor differentiation was missing in 9 (4.0%) PR; tumor budding was missing in 24 (10.8%) PR; lympho-vascular invasion was missing in 9 (4.0%) PR. Overall, at least one histological feature was missing in 32 (14.3%) PR and at least two histological features were missing in 14 (6.3%) PR. Concerning the adherence to guidelines, 179 (82.1%) of the decisions were consistent with the guidelines. Regarding the 39 (17.9%) patients for whom the guidelines were not followed, 19/39 (48.7%) were not operated because they declined or were not fit for surgery, which brings to 20/218 (9.2%) the number of patients deviating from the guidelines without justification.

Conclusions This multicenter study indicates that 14% of pathology reports for endoscopically resected T1CRC are incomplete and that patient management deviates from international guidelines without justification in 9% of patients. The creation of a dedicated multidisciplinary meeting for superficial gastro-intestinal cancers in each therapeutic endoscopy center could help improving these points.