Audit of Gastric Cancer Pathology Reports in Yazd

Corresponding Author: Ali Akhavan, MD Shahid Ramezanzadeh Radiation Oncology Center, Shahid Sadoughi Medical University, Shahid Motahhari Ave., Yazd, Iran Tel: +983517251171 Fax: +983517244078 Email:[email protected] Introduction Throughout the 20th century, adenocarcinoma of the stomach has been the leading cause of cancerrelated deaths worldwide. It now ranks second only to lung cancer.1 According to global estimates, more than 930,000 new cases of gastric cancer are diagnosed each year and a minimum of 700,000 patients die from this disease.2 In Iran, this is a fatal, endemic disease with about 7300 new cases diagnosed annually. Gastric cancer is the most common cancer in men. Mortality from gastric cancer is also the first cause of death due to cancer in both sexes in Iran.3 Surgery is the primary treatment. Adequate surgical resection, Abstract Background: The intent of this study was to audit and evaluate the information content of pathology reports of resected gastric cancer specimens in Yazd, Iran. Methods: All gastric cancer reports of patients from the histopathology laboratories in Yazd over a six-year period who referred for adjuvant radiation therapy to Shahid Ramazanzadeh Radiation Oncology Center were evaluated for their information content. A standard was adapted from the Nationwide guideline, version 1.0 of Netherland that explained the minimum data set for gastric cancer pathology reports that included: histologic type, grade, T stage, N stage, distance between the tumor and nearest resection margin, tumor size and, location, as well as perineural, lymphatic and vascular invasion. Results: We audited 56 reports. Unfortunately, none of the reports were adequate. Tumor subtype was not reported in 80.4% of patients, grade in 16.1%, T stage in 8.9%, N stage in 26.8%, margin in 57.1%, tumor size in 10.7%, and location in 41.1%. Conclusion: This audit showed a need to improve the information content of gastric cancer pathology reports. The widespread implementation of template proforma reporting is proposed as the most effective way of achieving this goal. On the other hand, improving surgical techniques, adequate lymph node resection and tumor resection with adequate margins is necessary