279 Quality and Prognostic Value of Colorectal Cancer Pathology Reports

Abstract

Abstract Aim Comprehensive pathology reports are essential to inform clinical decision-making. An internal audit was conducted to determine whether the Trust Histopathology department fulfilled histopathological reporting standards for colorectal cancer (CRC) by the Royal College of Pathologists (RCPath). Methods Pathology reports for CRC surgical resection specimens between 2018-2021, were reviewed. Resections were from symptomatic (non-screening) patients, with no preoperative treatment. Benign or endoscopically obtained specimens, and non-primary CRC were excluded. Reports were reviewed for compliance with the CRC categories: I. median number of lymph nodes attained (≥12 per specimen) II. cases showing extramural venous spread (≥30%) III. cases showing peritoneal/serosal involvement (≥20%). Results 277 reports were included. Median lymph node yield was consistently >12, throughout. >30% of specimens demonstrated venous invasion between 2018-2020, however, 24% of specimens in 2021. Nearly all reports commented on the depth of venous invasion (e.g. ‘intramural’/‘extramural’) by 2021. >20% specimens demonstrated peritoneal involvement between 2018-2020, however this was 16% in 2021. Conclusions The quality of reports was high and consistent. There was overall compliance with the RCPath requirement. Results from 2021 may be affected by changes to pre-COVID CRC treatment pathways, with more patients presenting at a more advanced stage and receiving initial neoadjuvant treatment. As venous invasion is an independent prognostic indicator, documenting the extent of invasion is a quality assurance factor.