Pathology slide review is mandatory before planning treatment for referral patients with gynecologic cancer

Abstract

AbstractObjective: To evaluate the impact of a pathology slide review on the management of gynecologic cancer patients.Materials and methods: The medical records of referral patients, with the original pathologic diagnosis of gynecologic cancer treated at Chiang Mai University Hospital between January 2002 and May 2003, were retrospectively reviewed.Results: During the study period, 402 cases were available for analysis. The slides reviewed were obtained from the following organs: cervix (305), ovary (33), endometrium (32), vulva (14), and others (17). In comparison between the diagnosis after slide review and the original referral diagnosis, the minor discrepancy rate was 41.5% (95% CI: 36.7–46.5%). The major discrepancy rate was 9.0% (95% CI: 6.3–12.2%) and the most common clinical consequence was the modification of planned surgery. There was no major diagnostic discrepancy in the vulvar specimens. Among patients with cervical neoplasia, there was a significantly lower rate of major discrepancy among patients with gross lesion than among those without (P < 0.001).Conclusion: Major diagnostic discrepancies were identified in 9% of referral patients with gynecologic cancer. A pathology slide review is strongly recommended before planning treatment to improve the quality of patient care.