Validation of the German classification system for quality assessment of right-sided colon cancer specimens
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The German classification system of the completeness of mesocolic excision aims to assess the quality of right-sided colonic cancer surgery by review of photographs. We aimed to validate the reliability of the classification in a clinical context.
Method
The study was based on a cohort of patients undergoing resection for right-sided colon cancer in two university hospitals served by the same group of pathologists. Prospectively collected photographs of the specimens were assessed twice by six colorectal surgeons to determine the intra-rater and inter-rater accuracy of the German classification and a modification assessing extended right-sided resections.
Results
Specimens from 613 resections for right-sided colon cancer were reviewed. Twenty-one specimens were found to be non-assessable, leaving 436 right hemicolectomies, 139 extended right hemicolectomies and 17 right-sided subtotal colectomies. Intra-rater reliability was 0.57–0.74 and weighted kappa coefficients 0.58–0.74, without differences between subgroups. The percentage of agreement between all six participants was 20.3% for all specimens, 21.1% for right hemicolectomy specimens and 18.1% for extended hemicolectomy and right-sided subtotal colectomy specimens. For the right hemicolectomy specimens, the model-based kappa coefficient for agreement was 0.27 (95% CI 0.24–0.30) and for association 0.45 (95% CI 0.41–0.49).
Conclusion
The German classification of right hemicolectomy specimens showed low intra-rater reliability and inter-rater agreement and association. The use of this classification for scientific purposes appeared not to be reliable.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Colorectal Disease |
| Vol/bind | 25 |
| Udgave nummer | 8 |
| Sider (fra-til) | 1622-1630 |
| Antal sider | 9 |
| ISSN | 1462-8910 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
The study was funded by the Tvergaard Fond, the Helen Rude Fond, the Edgar & Hustru Gilberte Schnohrs Fond, the KV Fonden, the Olga Bryde Nielsen Fond, the Else & Mogens Wedell‐Wedellsborg Fond and the Inger & Hakon Fabricius Fond. The funding sources had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. CAB had access to all data, and as corresponding author had the final responsibility to submit for publication.
Funding Information:
The study was funded by the Tvergaard Fond, the Helen Rude Fond, the Edgar & Hustru Gilberte Schnohrs Fond, the KV Fonden, the Olga Bryde Nielsen Fond, the Else & Mogens Wedell-Wedellsborg Fond and the Inger & Hakon Fabricius Fond. The funding sources had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. CAB had access to all data, and as corresponding author had the final responsibility to submit for publication.
Publisher Copyright:
© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
ID: 363437612