Abstract
AimTo determine the incidence of discrepancy rate between the initial pathology diagnosis and referral diagnosis in women with gynaecological cancer.MethodsA retrospective observational study was performed including all consecutive patients with gynaecological cancer referred and who underwent pathologic review between January 2013 and May 2017. Discrepancies were minor when future treatment was not altered or major when the treatment was modified.ResultsA total of 259 patients were included. The original diagnosis was ovarian cancer (n = 126, 48.6%), endometrial cancer (n = 84, 32.4%), cervical cancer (n = 43, 16.6%) and vulvar cancer (n = 6, 2.3%). Eighteen women (6.9%) had major discrepancies and 69 patients (26.6%) had minor discrepancies. The main reason for the minor discrepancy was tumour grade or histology subtype. Regarding ovarian cancer, 13 out of 16 patients had minor discrepancies at histology subtype among serous, endometrioid, mucinous or undifferentiated tumours. The main issue for the minor discrepancy in patients with cervical cancer was among different subtype of cervical adenocarcinoma. Minor discrepancies due to tumour grade were also observed in 14, 19, 8 and 3 patients with endometrial, ovarian, cervical and vulvar cancer, respectively.ConclusionsA second pathology review also adds valid information in those cases with minor discrepancies leading to a difference in patients´ counselling regarding follow-up and prognosis.
Highlights
Discrepancy in the pathology diagnosis is possible among different pathologists [1]
The type of discrepancy was classified in accordance with other authors [1, 3, 7, 9] as: minor discrepancy, when it did not impact on future clinical practice; and major discrepancy, when it did modify the patients future planned treatment
Pathology review was required in 259 patients with gynaecological cancer who attended the Instituto Valenciano de Oncología (IVO) for a second opinion, representing the analysed patients in this study
Summary
Discrepancy in the pathology diagnosis is possible among different pathologists [1]. The disagreement seems to be more frequent for gynaecological pathologies [2]. Secondary pathology review for gynaecological cancer is a common practice at referral centres [3]. It is defined as the review of pathology specimens, by a second. Publication costs for this article were supported by the ecancer Global Foundation.
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