TY - JOUR
T1 - Interlaboratory Variability in the Histologic Grading of Colorectal Adenocarcinomas in a Nationwide Cohort
AU - Kuijpers, Chantal C H J
AU - Sluijter, Caro E.
AU - von der Thüsen, Jan H.
AU - Grünberg, Katrien
AU - van Oijen, Martijn G H
AU - van Diest, Paul J.
AU - Jiwa, Mehdi
AU - Nagtegaal, Iris D.
AU - Overbeek, Lucy I H
AU - Willems, Stefan M.
PY - 2016/8
Y1 - 2016/8
N2 - Differentiation grade of colorectal adenocarcinoma (CRC) is a prognostic factor and important for therapy selection. In patients with stage II colon cancer, poor differentiation is an indication for adjuvant chemotherapy. The variability in daily practice in the grading of CRC was assessed in a nationwide cohort. Using the Dutch Pathology Registry (PALGA), all synoptically reported CRC resections from 2010 to 2013 were identified. Proportions of poorly differentiated (PD) adenocarcinomas were determined and compared between 35 laboratories by univariable and multivariable logistic regression analyses. In total, 11,719 resections of 11,681 patients were included, of which 1427 (12.2%) were PD (range between 35 laboratories: 5.0% to 33.2%). After adjustment for case mix, 4 (11%) laboratories still reported a significantly lower (n=2) or higher (n=2) proportion of PD adenocarcinoma compared with the reference laboratory. Seven of 8 investigated laboratories showed considerable intralaboratory variation between pathologists as well. In a subgroup of 2812 patients (2813 tumors) who could have been eligible for adjuvant chemotherapy solely on the basis of the differentiation grade (stage II colon cancer patients without other high-risk factors [ie, T4,
AB - Differentiation grade of colorectal adenocarcinoma (CRC) is a prognostic factor and important for therapy selection. In patients with stage II colon cancer, poor differentiation is an indication for adjuvant chemotherapy. The variability in daily practice in the grading of CRC was assessed in a nationwide cohort. Using the Dutch Pathology Registry (PALGA), all synoptically reported CRC resections from 2010 to 2013 were identified. Proportions of poorly differentiated (PD) adenocarcinomas were determined and compared between 35 laboratories by univariable and multivariable logistic regression analyses. In total, 11,719 resections of 11,681 patients were included, of which 1427 (12.2%) were PD (range between 35 laboratories: 5.0% to 33.2%). After adjustment for case mix, 4 (11%) laboratories still reported a significantly lower (n=2) or higher (n=2) proportion of PD adenocarcinoma compared with the reference laboratory. Seven of 8 investigated laboratories showed considerable intralaboratory variation between pathologists as well. In a subgroup of 2812 patients (2813 tumors) who could have been eligible for adjuvant chemotherapy solely on the basis of the differentiation grade (stage II colon cancer patients without other high-risk factors [ie, T4,
KW - grading, colorectal cancer, variability, standardization, quality of care
UR - http://www.scopus.com/inward/record.url?scp=84961218460&partnerID=8YFLogxK
U2 - 10.1097/PAS.0000000000000636
DO - 10.1097/PAS.0000000000000636
M3 - Article
C2 - 26975039
AN - SCOPUS:84961218460
SN - 0147-5185
VL - 40
SP - 1100
EP - 1108
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
IS - 8
ER -