The role of pathologists in the quality control of diagnosis and treatment of rectal cancer - an overview

Pathological examination of the rectal cancer resection specimen has an increasingly important role in influencing decisions about clinical management. Standardisation of the examination procedures and reporting are necessary. To evaluate the relevant pathological factors, data from randomised clinical trials with adequate follow-up are necessary. From a recently closed trial on the treatment of rectal cancer (preoperative radiotherapy or total mesorectal excision (TME) surgery alone?), the pathological data were used to evaluate the importance of pathological factors, like circumferential margin and tumour, lymph nodes, metastasis (TNM) stage. Furthermore, it was possible to evaluate the surgical procedures and correlate these findings to clinically relevant endpoints. In this review, we describe the standard evaluation of a rectal cancer specimen with special attention to preoperative irradiated specimens. (C) 2002 Elsevier Science Ltd. All rights reserved.