Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma

PurposeIn pT1 rectal adenocarcinoma, adverse pathological features guide the indication for radical surgery; however, they are present in only 10-15% of cases. Therefore, in most patients, accurate en bloc local excision with clear margins and precise submucosal invasion assessment is essential for...

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Autores: Gener-Jorge, C, Piñas, JCF, Garcia, ABM, Rivera, DSM, Casalots, A, Nonell, A, Espina, B, Caro-Tarragó, A, Serra-Aracil, X
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p20244
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20244
Access Level:acceso abierto
Palabra clave:T1 rectal adenocarcinoma
Submucosal invasion
Prognosis of T1 rectal adenocarcinoma
Healthy residual submucosa
TEM
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spelling Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinomaGener-Jorge, CPiñas, JCFGarcia, ABMRivera, DSMCasalots, ANonell, AEspina, BCaro-Tarragó, ASerra-Aracil, XT1 rectal adenocarcinomaSubmucosal invasionPrognosis of T1 rectal adenocarcinomaHealthy residual submucosaTEMPurposeIn pT1 rectal adenocarcinoma, adverse pathological features guide the indication for radical surgery; however, they are present in only 10-15% of cases. Therefore, in most patients, accurate en bloc local excision with clear margins and precise submucosal invasion assessment is essential for appropriate risk stratification. Beyond absolute depth, a major challenge is the wide interindividual variability in submucosal thickness. The Taul & iacute;-pT1 classification, based on the measurement of healthy residual submucosa (hrSB) from the muscularis propria, has been proposed as an objective and reproducible system. This study aimed to validate this classification.MethodAn interobserver study was conducted on 30 patients with pT1 rectal adenocarcinoma treated by transanal endoscopic surgery. Four pathologists with varying experience levels independently evaluated digitized histological slides, measuring hrSB, total submucosal thickness, and invasion depth. They also classified specimens as sm1, sm2, or sm3. Interobserver agreement was assessed using intraclass correlation coefficients (ICC), and Fleiss' and Cohen's kappa indices.ResultsExcellent interobserver agreement was observed for hrSB (ICC = 0.99; 95% CI: 0.98-0.99), total submucosal thickness (ICC = 0.96; 95% CI: 0.93-0.98), and depth of invasion (ICC = 0.94; 95% CI: 0.9-0.97). The Taul & iacute;-pT1 classification demonstrated good agreement (Fleiss' kappa = 0.71). Identification of the muscularis mucosae showed moderate agreement (kappa = 0.612).ConclusionThe Taul & iacute;-pT1 classification demonstrates high interobserver reproducibility, even among pathologists with varying levels of experience, supporting its utility as an objective and standardized tool for the assessment of pT1 rectal adenocarcinoma.Clinical trial registrationClinicalTrials.gov Identifier: NCT06218108.SPRINGER2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20244INTERNATIONAL JOURNAL OF COLORECTAL DISEASEISSN: 01791958ISSNe: 14321262reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p202442026-06-14T12:41:47Z
dc.title.none.fl_str_mv Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
title Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
spellingShingle Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
Gener-Jorge, C
T1 rectal adenocarcinoma
Submucosal invasion
Prognosis of T1 rectal adenocarcinoma
Healthy residual submucosa
TEM
title_short Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
title_full Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
title_fullStr Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
title_full_unstemmed Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
title_sort Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma
dc.creator.none.fl_str_mv Gener-Jorge, C
Piñas, JCF
Garcia, ABM
Rivera, DSM
Casalots, A
Nonell, A
Espina, B
Caro-Tarragó, A
Serra-Aracil, X
author Gener-Jorge, C
author_facet Gener-Jorge, C
Piñas, JCF
Garcia, ABM
Rivera, DSM
Casalots, A
Nonell, A
Espina, B
Caro-Tarragó, A
Serra-Aracil, X
author_role author
author2 Piñas, JCF
Garcia, ABM
Rivera, DSM
Casalots, A
Nonell, A
Espina, B
Caro-Tarragó, A
Serra-Aracil, X
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv T1 rectal adenocarcinoma
Submucosal invasion
Prognosis of T1 rectal adenocarcinoma
Healthy residual submucosa
TEM
topic T1 rectal adenocarcinoma
Submucosal invasion
Prognosis of T1 rectal adenocarcinoma
Healthy residual submucosa
TEM
description PurposeIn pT1 rectal adenocarcinoma, adverse pathological features guide the indication for radical surgery; however, they are present in only 10-15% of cases. Therefore, in most patients, accurate en bloc local excision with clear margins and precise submucosal invasion assessment is essential for appropriate risk stratification. Beyond absolute depth, a major challenge is the wide interindividual variability in submucosal thickness. The Taul & iacute;-pT1 classification, based on the measurement of healthy residual submucosa (hrSB) from the muscularis propria, has been proposed as an objective and reproducible system. This study aimed to validate this classification.MethodAn interobserver study was conducted on 30 patients with pT1 rectal adenocarcinoma treated by transanal endoscopic surgery. Four pathologists with varying experience levels independently evaluated digitized histological slides, measuring hrSB, total submucosal thickness, and invasion depth. They also classified specimens as sm1, sm2, or sm3. Interobserver agreement was assessed using intraclass correlation coefficients (ICC), and Fleiss' and Cohen's kappa indices.ResultsExcellent interobserver agreement was observed for hrSB (ICC = 0.99; 95% CI: 0.98-0.99), total submucosal thickness (ICC = 0.96; 95% CI: 0.93-0.98), and depth of invasion (ICC = 0.94; 95% CI: 0.9-0.97). The Taul & iacute;-pT1 classification demonstrated good agreement (Fleiss' kappa = 0.71). Identification of the muscularis mucosae showed moderate agreement (kappa = 0.612).ConclusionThe Taul & iacute;-pT1 classification demonstrates high interobserver reproducibility, even among pathologists with varying levels of experience, supporting its utility as an objective and standardized tool for the assessment of pT1 rectal adenocarcinoma.Clinical trial registrationClinicalTrials.gov Identifier: NCT06218108.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20244
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20244
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER
publisher.none.fl_str_mv SPRINGER
dc.source.none.fl_str_mv INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
ISSN: 01791958
ISSNe: 14321262
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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