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Standardised reporting protocol for endoscopic resection for Barrett oesophagus associated neoplasia: expert consensus recommendations

Kumarasinghe, M. P.1; Brown, I.2; Raftopoulos, S.3; Bourke, M. J.4; Charlton, A.5; de Boer, W. B.1; Eckstein, R.6; Epari, K.7; Gill, A. J.6,8; Lam, A. K.9; Price, T.10; Streutker, C.11; Lauwers, G. Y.12

Pathology:
doi: 10.1097/PAT.0000000000000160
Reviews
Abstract

Summary: Endoscopic resection (ER) is considered the therapy of choice for intraepithelial neoplasia associated with visible lesions and T1a adenocarcinoma. Pathologists are bound to encounter specimens collected via these techniques more frequently in their practice. A standardised protocol for handling, grossing, and assessing ER specimens should be adopted to ensure that all prognostic information and characteristics influencing treatment are included in reports (see Supplementary Video Abstract, http://links.lww.com/PAT/A22). The entire specimen should be appropriately oriented, processed and assessed. An ER specimen will commonly show intraepithelial neoplasia or invasive carcinoma. There are essential features that should be recorded if invasive carcinoma is found as they dictate further management and follow-up. These features are the margin status, depth of invasion, degree of differentiation and presence or absence of lymphovascular invasion. Important features such as duplication of muscularis mucosae should be recognised to avoid misinterpretation of depth of invasion. Key diagnostic and prognostic elements that are essential for optimal clinical decisions have been included in the reporting format proposed by the Structured Pathology Reporting committee of the Royal College of Pathologists of Australasia (RCPA).

Author Information

1PathWest, Queen Elizabeth II Medical Centre, Nedlands, and University of Western Australia, WA

2Envoi Pathology, Herston, Qld

3Sir Charles Gairdner Hospital, Nedlands, WA

4Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, and Westmead Clinical School, University of Sydney, Sydney, NSW

5Department of Histopathology, The Children's Hospital at Westmead, Sydney, NSW

6Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW

7St John of God Hospital Murdoch, Murdoch, and Department of Surgery, Fremantle Hospital, Fremantle, WA

8Cancer Diagnosis and Pathology Group, University of Sydney, NSW

9Griffith Medical School and Griffith Health Institute, Griffith University, Qld

10Department of Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia

11St. Michael's Hospital, Toronto, Canada

12Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States

Address for correspondence: Professor M. P. Kumarasinghe, PathWest, QE11, J Block Hospital Avenue, Nedlands, WA 6009, Australia. E-mail: Priyanthi.Kumarasinghe@health.wa.gov.au

Received 22 April, 2014

Revised 23 June, 2014

Accepted 26 June, 2014

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.rcpa-pathologyjournal.com).

© 2014 Royal College of Pathologists of Australasia

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