ABSTRACT
Background: A comprehensive histopathology report of colorectal carcinoma surgery is important in cancer staging and planning adjuvant treatment. Our aim was to review histopathology reports of operated specimens of colorectal carcinoma in our institution between 2013 and 2015 to assess different histological parameters, including lymph node yield, and to evaluate compliance to minimum data sets. Methods: After approval by the institutional review board (IRB), we analyzed 1230 histopathology reports of colorectal carcinoma between 2013 and 2015. Various gross and microscopic findings (along with age, sex) were noted, for example, specimen type, tumor site, resection margins including circumferential resection margin (CRM), lymphovascular invasion, perineural invasion, pTNM stage, lymph node yield, etc. Results: Out of 1230 patients, 826 (67.15%) were men and 404 (32.85%) were women. The overall mean age was 52 (range: 18 - 90) years. There were 787 surgeries for rectal cancers. All reports commented on the type of specimen, tumor size (mean = 4.38 cm), proximal, and distal margins. Lymphovascular invasion (LVI) and the pT stage were mentioned in 98.06% and 99.84%, respectively. The overall mean lymph node yield was 18.38 (median = 15, range = 0-130 lymph nodes). A statistically significant difference in lymph node yield was detected between rectal and colonic cancer patients (14.79 and 27.26); post neoadjuvant therapy (NACT) cases, and NACT naive cases (13.51 and 25.11); and high tumor stage and low tumor stage disease (20.60 and 15.22). Not commenting on extramural vascular emboli, tumor budding, and CRM in non-rectal cancer cases were the lacunae. Conclusion: Our compliance with minimal data sets is satisfactory. The overall mean lymph node yield was 18.38 (median = 15). Extramural vascular emboli, tumor budding need to be captured.
ABSTRACT
Context and Setting: Attainment of health objectives depends on the capacity building of all categories of staff. While Medical Education has some provision for faculty development, the existing initiatives for staff development are too few and floating. We describe our experience in conducting a pilot training program for the administrative staff at AIIMS. Need for innovation: The competency and motivation of the administrative staff are crucial for better public dealing, and for organization’s effectiveness. In the existing system, there was no such mechanism to drive these. Description of innovation: We selected Assistants and Office Supervisors (71) for the training program. Based on brain storming meetings with administrators and keeping in view the time constraints, we identified four modules - Team building, Effective Communication, Stress management and Use of computers (Application of MS Office).Each module was of three hours duration conducted by medical faculty, educationists and management experts. All sessions were highly interactive including case scenarios, exercises, games, role play and psychometric tools. We obtained feedback from the participants to evaluate the effectiveness. Lessons learnt: An overwhelming majority (>90% participants) perceived the content and the training process as “Highly Useful” (strongest rating). The trainees found ‘Computer Application’ highly useful, because of its utility potential. ‘Communication skills’, ‘Team work’ and ‘Stress management’ were also perceived as useful for their professional and personal lives. Effective collaboration of medical faculty, educationists and management experts led to the success of this program. We recommend that such model should be a regular feature and be linked with performance appraisal.