Evaluation of pathology review at gynaecological oncology multidisciplinary team meetings: a 5-year prospective analysis of cases with major diagnostic discordance
| Autor: | Bret Snowball, Anup Naran, Anita Soma, Zia Chaudry, Sukeerat Ruba, Yee Leung, Myfanwy Plunkett, M.H. Eleanor Koay, Colin J.R. Stewart |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty Serous carcinoma Genital Neoplasms Female Adenocarcinoma Multidisciplinary team Medical Oncology Pathology and Forensic Medicine Metastasis 03 medical and health sciences Prospective analysis 0302 clinical medicine medicine Humans Prospective Studies Pathological business.industry Gynaecological oncology medicine.disease Squamous carcinoma 030104 developmental biology Gynecology 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Interdisciplinary Communication business |
| Zdroj: | Pathology. 51(4) |
| ISSN: | 1465-3931 |
| Popis: | Multidisciplinary team meetings (MDTs) play an essential role in the management of patients with newly diagnosed and recurrent cancers, and often include review of pathology specimens that were initially assessed in external departments. Many studies have demonstrated a low but significant rate of diagnostic disagreement following such review but the pathological findings have seldom been detailed. We present a prospective 5-year study of all external cases reviewed at the Western Australian Gynaecological Oncology MDT focusing upon those cases with major diagnostic discordance likely to impact patient management. In total, 1275 cases were reviewed of which 132 (10.4%) were considered discordant including 48 (3.8%) with major discordance. Different interpretation of the presence and/or extent of tumour invasion accounted for a significant proportion of cases and in particular some adenocarcinoma and squamous carcinoma variants were initially reported to show only in situ or minimally invasive disease. Endometrial high-grade serous carcinoma was under-recognised and on occasion reassignment of tumour origin including metastasis to the gynaecological tract was facilitated by additional clinical information and supported by appropriate immunohistochemistry. This study supports the role of pathology review at MDTs and highlights problematic lesions that may merit a low threshold for additional opinion and ancillary studies. |
| Databáze: | OpenAIRE |
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