Which classification system grades the quality of total mesorectal excision (TME) specimens and correlates directly with local recurrence risk in rectal cancer surgery?
- A Quirke grading system (mesorectal, intramesorectal, muscularis propria planes) ✓
- B Dukes classification system
- C Astler-Coller modification
- D AJCC TNM 8th edition pathological staging
Explanation
Phil Quirke's pathological grading of TME specimens into three planes—mesorectal (complete, smooth envelope), intramesorectal (moderate, irregular envelope), and muscularis propria (incomplete, deep defects)—directly correlates with local recurrence rate and circumferential resection margin involvement. Complete mesorectal plane dissection is associated with <5% local recurrence. This quality assurance tool transformed rectal cancer surgery. Dukes and Astler-Coller are staging systems, not specimen quality assessments. TNM staging classifies extent of disease, not surgical quality.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.