Consensus recommendations for the standardized histopathological evaluation and reporting after radical oesophago-gastrectomy (HERO consensus)
Consensus recommendations for the standardized histopathological evaluation and reporting after radical oesophago-gastrectomy (HERO consensus)
BACKGROUND: Variation in the approach, radicality, and quality of gastroesophageal surgery impacts patient outcomes. Pathological outcomes such as lymph node yield are routinely used as surrogate markers of surgical quality, but are subject to significant variations in histopathological evaluation and reporting. A multi-society consensus group was convened to develop evidence-based recommendations for the standardized assessment of gastroesophageal cancer specimens.
METHODS: A consensus group comprised of surgeons, pathologists, and oncologists was convened on behalf of the Association of Upper Gastrointestinal Surgery of Great Britain & Ireland. Literature was reviewed for 17 key questions. Draft recommendations were voted upon via an anonymous Delphi process. Consensus was considered achieved where >70% of participants were in agreement.
RESULTS: Consensus was achieved on 18 statements for all 17 questions. Twelve strong recommendations regarding preparation and assessment of lymph nodes, margins, and reporting methods were made. Importantly, there was 100% agreement that the all specimens should be reported using the Royal College of Pathologists Guidelines as the minimum acceptable dataset. In addition, two weak recommendations regarding method and duration of specimen fixation were made. Four topics lacked sufficient evidence and no recommendation was made.
CONCLUSIONS: These consensus recommendations provide explicit guidance for gastroesophageal cancer specimen preparation and assessment, to provide maximum benefit for patient care and standardize reporting to allow benchmarking and improvement of surgical quality.
cancer, cancer staging, circumferential resection margin, histology, istopathology, lymphadenectomy
Pucher, Philip H
6b51dabb-77c2-40c6-bfa7-1daa3f82c0a6
Allum, William H
19a9b8a7-e082-4450-9703-ca80b5456087
Bateman, Adrian C
e302a81f-ca4c-48ae-9145-bff4e1ebef87
Green, Michael
857b7cfd-a289-4143-9eb0-90434825a47d
Maynard, Nick
b1551de8-a068-4e5d-89d2-9d47540c0dff
Novelli, Marco
6e75fff4-a510-4a85-a9da-969b8d91c969
Petty, Russell
b939c114-e5f3-4d46-ad6e-b31c2cfcc704
Underwood, Timothy J
8e81bf60-edd2-4b0e-8324-3068c95ea1c6
Gossage, James
17d9224b-b967-45af-9a09-6a113b53fb69
10 August 2021
Pucher, Philip H
6b51dabb-77c2-40c6-bfa7-1daa3f82c0a6
Allum, William H
19a9b8a7-e082-4450-9703-ca80b5456087
Bateman, Adrian C
e302a81f-ca4c-48ae-9145-bff4e1ebef87
Green, Michael
857b7cfd-a289-4143-9eb0-90434825a47d
Maynard, Nick
b1551de8-a068-4e5d-89d2-9d47540c0dff
Novelli, Marco
6e75fff4-a510-4a85-a9da-969b8d91c969
Petty, Russell
b939c114-e5f3-4d46-ad6e-b31c2cfcc704
Underwood, Timothy J
8e81bf60-edd2-4b0e-8324-3068c95ea1c6
Gossage, James
17d9224b-b967-45af-9a09-6a113b53fb69
Pucher, Philip H, Allum, William H, Bateman, Adrian C, Green, Michael, Maynard, Nick, Novelli, Marco, Petty, Russell, Underwood, Timothy J and Gossage, James
(2021)
Consensus recommendations for the standardized histopathological evaluation and reporting after radical oesophago-gastrectomy (HERO consensus).
Diseases of the Esophagus, 34 (8), [doab033].
(doi:10.1093/dote/doab033).
Abstract
BACKGROUND: Variation in the approach, radicality, and quality of gastroesophageal surgery impacts patient outcomes. Pathological outcomes such as lymph node yield are routinely used as surrogate markers of surgical quality, but are subject to significant variations in histopathological evaluation and reporting. A multi-society consensus group was convened to develop evidence-based recommendations for the standardized assessment of gastroesophageal cancer specimens.
METHODS: A consensus group comprised of surgeons, pathologists, and oncologists was convened on behalf of the Association of Upper Gastrointestinal Surgery of Great Britain & Ireland. Literature was reviewed for 17 key questions. Draft recommendations were voted upon via an anonymous Delphi process. Consensus was considered achieved where >70% of participants were in agreement.
RESULTS: Consensus was achieved on 18 statements for all 17 questions. Twelve strong recommendations regarding preparation and assessment of lymph nodes, margins, and reporting methods were made. Importantly, there was 100% agreement that the all specimens should be reported using the Royal College of Pathologists Guidelines as the minimum acceptable dataset. In addition, two weak recommendations regarding method and duration of specimen fixation were made. Four topics lacked sufficient evidence and no recommendation was made.
CONCLUSIONS: These consensus recommendations provide explicit guidance for gastroesophageal cancer specimen preparation and assessment, to provide maximum benefit for patient care and standardize reporting to allow benchmarking and improvement of surgical quality.
Text
HERO consensus full draft_PP3_rev1
Restricted to Repository staff only
Request a copy
More information
Published date: 10 August 2021
Keywords:
cancer, cancer staging, circumferential resection margin, histology, istopathology, lymphadenectomy
Identifiers
Local EPrints ID: 453256
URI: http://eprints.soton.ac.uk/id/eprint/453256
ISSN: 1120-8694
PURE UUID: 1f6265e3-5851-48c3-9c91-730b8ef764c3
Catalogue record
Date deposited: 11 Jan 2022 17:48
Last modified: 17 Mar 2024 02:58
Export record
Altmetrics
Contributors
Author:
Philip H Pucher
Author:
William H Allum
Author:
Adrian C Bateman
Author:
Michael Green
Author:
Nick Maynard
Author:
Marco Novelli
Author:
Russell Petty
Author:
James Gossage
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
