A retrospective comparison of first and second opinion histopathology with patient outcomes in veterinary oncology cases (2011–2019)
| Autor: | Samuel E. Hocker, Valerie J. Poirier, Sarah Laliberte, Robert A. Foster, Christopher J Pinard |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
General Veterinary business.industry Medical record General surgery Second opinion Veterinary oncology Malignancy medicine.disease Natural history of disease Mitotic Count Surgical pathology Neoplasms Animals Humans Medicine Histopathology business Referral and Consultation Retrospective Studies |
| Zdroj: | Veterinary and Comparative Oncology. 20:198-206 |
| ISSN: | 1476-5829 1476-5810 |
| Popis: | Mandatory second opinion histopathology is common practice in human surgical pathology. It is intended to confirm the original diagnosis or identify clinically significant discrepancies, which could alter the course of disease, cost of treatment, patient management or prognosis. This retrospective analysis aimed to evaluate agreement between 1st and 2nd opinion histopathology cases, examine their correlation with natural history of disease and investigate the rationale for pursuing this test. Medical records from 2011 to 2019 were reviewed, identifying 109 cases where 2nd opinion histopathology was sought. Reasons for seeking 2nd opinion and clinical disease course were also reviewed to determine whether case progression favored 1st or 2nd opinion findings in cases of diagnostic disagreement. Diagnostic disagreement was found in 49.5% of cases. Complete diagnostic disagreement (a change in degree of malignancy or tumor type) occurred in 15.6% cases and partial disagreement (a change in tumor subtype, grade, margins, mitotic count) occurred in 33.9%. Major disagreement (a change in diagnosis resulting in alteration of treatment recommendations) occurred in 38.5% of cases. The most common reasons for seeking 2nd opinion were an atypical/poorly differentiated tumor (31.2%; 34/109) or a discordant clinical picture (24.8%; 27/109). Among cases with any form of disagreement, natural history of disease favored 2nd opinion findings in 33.3%. The 1st opinion was favored over the 2nd in a single case. These findings reinforce previous literature supporting a role for 2nd opinion histopathology in optimizing therapy and predicting outcomes in veterinary oncology, particularly in cases where diagnosis is in question based on the overall clinical picture. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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