Completeness Of Pathology Reports Research Articles

Completeness of Colorectal Cancer Pathology Reports in Iranian National Population-Based Cancer Registry System

Background: Colorectal cancer is one of the top 5 common cancers in Iran with over 1.9 million new cases. Completeness of pathology reports is one of the key factors of cancer care management. So, sufficient reporting of pathological factors is vital for optimum diagnosis, projection of prognosis and patient care. Objectives: To support epidemiological research, we determined the completeness of colorectal cancer pathology reports at the nationwide level. Methods: Accessing to the text of pathology reports from a web-based application that was created by the Iranian National Population-Based Cancer Registry (INPCR) was considered the most complete and reliable. We requested that the INPCR extracts their pathology records for manual review for colorectal cancer (ICD-10 code ‘C18’, ‘C19’, ‘C20’, and 'C21'). Results: Exclusion criteria were applied and 2092 pathology reports were analyzed. The mean age of patients was 61 years; 56% were male. A vast number of colorectal cancer cases were at T3-stage (colon 68.4%, rectal 58.6%) and N0-stage (colon 55.7%, rectal 57%). Information on key prognostic factors, such as lymphovascular and perineural was frequently lacking (22.7% and 35.7% missing, respectively). On the other hand, Tumor type and tumor grade had a high percentage of reporting (100% and 100%, respectively). In addition, our study revealed a low rate of overall complete reporting (colon 0.2%, rectal 1.1%). Conclusions: Optimum diagnosis, prediction of prognosis, and patient care require sufficient reporting of pathological factors, so efforts should be made to improve the reporting of overall pathology factors of Colorectal cancer (CRC).

Completeness of pathology reports in stage II colorectal cancer

Introduction: The completeness of the pathological examination of resected colon cancer specimens is important for further clinical management. We reviewed the pathological reports of 356 patients regarding the five factors (pT-stage, tumor differentiation grade, lymphovascular invasion, tumor perforation and lymph node metastasis status) that are used to identify high-risk stage II colon cancers, as well as their impact on overall survival (OS).Methods: All patients with stage II colon cancer who were included in the first five years of the MATCH study (1 July 2007 to 1 July 2012) were selected (n = 356). The hazard ratios of relevant risk factors were calculated using Cox Proportional Hazards analyses.Results: In as many as 69.1% of the pathology reports, the desired information on one or more risk factors was considered incomplete. In multivariable analysis, age (HR: 1.07, 95%CI 1.04–1.10, p < .001), moderately- (HR: 0.35, 95%CI 0.18–0.70, p = .003) and well (HR 0.11, 95%CI 0.01–0.89, p = .038) differentiated tumors were significantly associated with OS.Conclusions: Pathology reports should better describe the five high-risk factors, in order to enable proper patient selection for further treatment. Chemotherapy may be offered to stage II patients only in select instances, yet a definitive indication is still unavailable.

The effects of implementing synoptic pathology reporting in cancer diagnosis: a systematic review.

Pathology reporting is evolving from a traditional narrative report to a more structured synoptic report. Narrative reporting can cause misinterpretation due to lack of information and structure. In this systematic review, we evaluate the impact of synoptic reporting on completeness of pathology reports and quality of pathology evaluation for solid tumours. Pubmed, Embase and Cochrane databases were systematically searched to identify studies describing the effect of synoptic reporting implementation on completeness of reporting and quality of pathology evaluation of solid malignant tumours. Thirty-three studies met the inclusion criteria. All studies, except one, reported an increased overall completeness of pathology reports after introduction of synoptic reporting (SR). Most frequently studied cancers were breast (n = 9) and colorectal cancer (n = 16). For breast cancer, narrative reports adequately described ‘tumour type’ and ‘nodal status’. Synoptic reporting resulted in improved description of ‘resection margins’, ‘DCIS size’, ‘location’ and ‘presence of calcifications’. For colorectal cancer, narrative reports adequately reported ‘tumour type’, ‘invasion depth’, ‘lymph node counts’ and ‘nodal status’. Synoptic reporting resulted in increased reporting of ‘circumferential margin’, ‘resection margin’, ‘perineural invasion’ and ‘lymphovascular invasion’. In addition, increased numbers of reported lymph nodes were found in synoptic reports. Narrative reports of other cancer types described the traditional parameters adequately, whereas for ‘resection margins’ and ‘(lympho)vascular/perineural invasion’, implementation of synoptic reporting was necessary. Synoptic reporting results in improved reporting of clinical relevant data. Demonstration of clinical impact of this improved method of pathology reporting is required for successful introduction and implementation in daily pathology practice.Electronic supplementary materialThe online version of this article (doi:10.1007/s00428-016-1935-8) contains supplementary material, which is available to authorized users.

Monitoring surgical treatment of screen-detected breast lesions in Italy

The object of this study was to assess quality of care and adherence to treatment guidelines of screen-detected lesions in Italy using a new audit system. Data on screen-detected cases surgically treated in 1997 were collected using a system (QT 2.3) developed within the Italian Group for Planning and Evaluating Mammographic Screening Programmes (GISMa) and the European Breast Cancer Screening Network. Results of 18 performance parameters were considered compared with the reference standards. In 1997, 515 lesions (335 invasive, 60 in situ and 120 benign) in 496 patients were collected from 14 departments in the Central and Northern area of Italy. The 18 indicators were analysed and grouped according to six quality objectives. Some results were good and others were excellent, such as intraoperative identification, breast conservation surgery, adequate axillary procedures and completeness of pathology reports, but most of them failed: waiting times, preoperative diagnosis, employment of frozen section on small lesions and avoiding axillary procedures in ductal carcinoma- in-situ. This work is a first attempt in Italy to evaluate and uniform the criteria adopted for quality control of breast cancer treatment, using a standardised system. Some results are good or excellent, the overall level of compliance with quality indicators is not satisfactory and corrective actions should be undertaken for a number of issues. A continuous monitoring should be performed and appropriate action taken in order to verify the effectiveness of the corrective actions and to provide screen-detected patients with the best quality of care.