Validation of the German classification system for quality assessment of right-sided colon cancer specimens
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Validation of the German classification system for quality assessment of right-sided colon cancer specimens. / Bertelsen, Claus Anders; Olsen, Anna Sofie Friis; Gundestrup, Anders Kierkegaard; Karlsen, Andreas Aarenstrup; Neuenschwander, Anders Ulrich; Buchbjerg, Thomas; Iversen, Else Refsgaard; Bols, Birgitte; Ingeholm, Peter; Kleif, Jakob.
In: Colorectal Disease, Vol. 25, No. 8, 2023, p. 1622-1630.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Validation of the German classification system for quality assessment of right-sided colon cancer specimens
AU - Bertelsen, Claus Anders
AU - Olsen, Anna Sofie Friis
AU - Gundestrup, Anders Kierkegaard
AU - Karlsen, Andreas Aarenstrup
AU - Neuenschwander, Anders Ulrich
AU - Buchbjerg, Thomas
AU - Iversen, Else Refsgaard
AU - Bols, Birgitte
AU - Ingeholm, Peter
AU - Kleif, Jakob
N1 - Publisher Copyright: © 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
PY - 2023
Y1 - 2023
N2 - Aim: 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.
AB - Aim: 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.
KW - colon cancer
KW - complete mesocolic excision
KW - quality of surgery
KW - right colon
KW - specimen
U2 - 10.1111/codi.16640
DO - 10.1111/codi.16640
M3 - Journal article
C2 - 37353896
AN - SCOPUS:85162904461
VL - 25
SP - 1622
EP - 1630
JO - Colorectal Disease
JF - Colorectal Disease
SN - 1462-8910
IS - 8
ER -
ID: 363437612