Pathologist second opinion significantly alters clinical management of pT1 endoscopically resected colorectal cancer

Gian Luca Rampioni Vinciguerra, Giulio Antonelli, Francesca Citron, Giammauro Berardi, Stefano Angeletti, Gustavo Baldassarre, Andrea Vecchione, Emilio Di Giulio, Emanuela Pilozzi

Research output: Contribution to journalArticlepeer-review


We retrospectively collected a series of 82 endoscopically removed early colorectal cancers. Histological specimens were revised by two gastrointestinal pathologists, performing a re-evaluation of all risk factors for lymph node metastasis. The comparison between second opinion and first pathological report revealed that lymphovascular invasion and tumor grading showed a lower level of concordance than other parameters. Our results demonstrated that second opinion modified risk assessment in about 10% of cases. It was mainly due to a lack in reporting of some parameters at the first diagnosis and a different evaluation in second opinion for updated guidelines. Considering the subgroup of patients with modified risk assessment, clinical data revealed that tumors, re-classified as low risk, did not develop lymph node metastasis that, conversely, occurred in patients identified as high risk by second opinion. In conclusion, second opinion significantly alters risk perception of endoscopically removed early colorectal carcinomas representing a valuable tool for their appropriate clinical management.

Original languageEnglish
Pages (from-to)665-668
Number of pages4
JournalVirchows Archiv
Issue number5
Publication statusPublished - Nov 1 2019


  • Colorectal carcinoma
  • Early colorectal carcinoma
  • Lymph node metastasis
  • Prognostic factors
  • Second opinion

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology


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