{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T10:32:54Z","timestamp":1776853974358,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A Michigan Surgical Quality Collaborative Colorectal Cancer Project initiative sought to increase adoption of surgeon total mesorectal excision (TME) grading through standardized education and synoptic operative reporting. Our study aim was to assess initiative impact and level of agreement between surgeon and pathologist\u2010determined TME grades.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective comparison of surgeon and pathologist TME grades before and after initiative implementation using a prospectively maintained enhanced recovery colorectal surgery database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 112 TMEs before, and 53 TMEs following initiative implementation. There was a significant increase in surgeon TME\u2010grade reporting in the postinitiative period (25.0% pre\u2010 vs. 81.1% post\u2010, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Pathologist TME\u2010grade reporting was high in both time periods and there was no significant change (91.1% pre\u2010 vs. 88.7% post\u2010, <jats:italic>p<\/jats:italic>\u2009=\u20090.84). Surgeon and pathologist agreement was 59.3% in the preinitiative period (<jats:italic>\u039a<\/jats:italic>\u00a0\u201cminimal\u201d\u2009\u00a0\u20090.356) and 65.0% in the postinitiative period (<jats:italic>\u039a<\/jats:italic>\u00a0\u201cmoderate\u201d\u2009=\u20090.605, <jats:italic>p<\/jats:italic>\u2009=\u20090.827). There was no significant association between clinical T\u2010stage and surgeon or pathologist TME grade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgeon TME grading improves with education and synoptic operative reporting. There is only moderate agreement between surgeon and pathologist, a finding that requires further study. Organized regional initiatives are effective at implementing rectal cancer management quality improvement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27214","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T12:51:13Z","timestamp":1676465473000},"page":"983-990","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of surgeon and pathologist total mesorectal excision grade after rectal cancer resection: A single institution analysis"],"prefix":"10.1002","volume":"127","author":[{"given":"Patrick J.","family":"Kato","sequence":"first","affiliation":[{"name":"Department of Surgery St Joseph Mercy Hospital Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arielle E.","family":"Kanters","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha J.","family":"Rivard","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Hendren","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Ramm","sequence":"additional","affiliation":[{"name":"Department of Academic Research St Joseph Mercy Hospital Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Albright","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Methods Consulting, BEMC, LLC Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate E.","family":"Schumaker","sequence":"additional","affiliation":[{"name":"Regional Tumor Registry Coordinator Trinity Health Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6375-7156","authenticated-orcid":false,"given":"Robert K.","family":"Cleary","sequence":"additional","affiliation":[{"name":"Department of Surgery St Joseph Mercy Hospital Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60485-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010580"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.133.8.894"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800830326"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.09.036"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002265"},{"key":"e_1_2_9_8_1","unstructured":"American College of Surgeons. Optimal Resources for Rectal Cancer Care. 2020 Standards.https:\/\/www.facs.org\/quality-programs\/cancer-programs\/national-accreditation-program-for-rectal-cancer\/"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24387"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002288"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000994"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001526"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0810119"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000606"},{"key":"e_1_2_9_16_1","unstructured":"Optimal Resources for Rectal Cancer Care (2020 Standards).https:\/\/www.facs.org\/quality-programs\/cancer-programs\/national-accreditation-program-for-rectal-cancer\/standards-and-resources\/"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.27214","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T05:07:37Z","timestamp":1696655257000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,15]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/jso.27214"],"URL":"https:\/\/doi.org\/10.1002\/jso.27214","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,15]]},"assertion":[{"value":"2023-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}