4. A comparison of synoptic and free-text reporting in oesophageal carcinoma

Abstract

Background Synoptic reporting of specimens of resected oesophageal carcinoma was introduced by the department of anatomical pathology at Royal North Shore Hospital (RNSH) in August 2007. Although synoptic reporting is widely regarded as resulting in better reporting quality, there is little hard evidence for this widespread belief. Aim The purpose of this study was to ascertain whether synoptic reporting of resected oesophageal carcinoma specimens resulted in better reporting of pertinent data for a single institution via the introduction of a minimum data set, compared with traditional free-text reporting. Methods 27 synoptic reports and 42 free-text reports from RNSH were compared. Results Tumour size was reported microscopically or macro-scopically in all synoptic reports and 38 (90.5%) free-text reports. Invasion depth was reported in all free-text reports and in 26 (96.3%) synoptic reports. Pathological stage was reported in only 4 (9.5%) free-text reports, compared to all synoptic reports. However, stage could be determined from all reports. Grade was reported in all synoptic reports, but not in 3 (7.1%) free text-reports. Surgical resection margins were reported at higher rates in the synoptic reports (in particular radial/circumferential margin), as were measurements of tumour to resection margins. Small vessel and perineural invasion were reported in all synoptic reports, but only 36 (85.7%) and 31 (73.8%) free-text reports, respectively. Degree of regression post-preoperative chemoradiation was reported in 25 (92.6%) synoptic reports, but only 8 (19%) free-text reports. Conclusion The introduction of synoptic reporting at RNSH has resulted in increased information being contained in surgical pathology reports.