Pathological Reporting of Colorectal Cancer Specimens: a Retrospective Survey in an Academic Canadian Pathology Department

Objective: To survey and improve the pathological reporting of colorectal cancer (CRC) specimens in a tertiary care pathology department.

Methods: We identified CRC specimens reported in a 6-month period before and after educational sessions and the introduction of a standardized CRC synoptic reporting protocol. Gross and microscopic descriptions were analyzed according to published guidelines for important staging and prognostic features. We then reexamined these parameters for a further 6-month period 15 months later to ensure that the quality of reporting had been maintained.

Results: In total, 108 and 166 cases were analyzed before and after standardization, respectively. Many features were reported appropriately, including tumour size, type and grade, depth of invasion, nodal status and proximal and distal margin status. Several underreported features showed significant improvement after standardization, including serosal involvement (reporting increased from 22% to 84%), distance to radial margin (from 14% to 64%), extramural venous invasion (from 18% to 88%), host response (from 19% to 94%) and mean number of nodes retrieved (mean numbers retrieved increased from 11 to 16). The subsequent review 15 months later showed continued long-term improvement in these areas.

Conclusion: Education and synoptic reporting significantly improved CRC reporting at our centre.