1
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Ellis I, Webster F, Allison KH, Dang C, Gobbi H, Kulka J, Lakhani SR, Moriya T, Quinn CM, Sapino A, Schnitt S, Sibbering DM, Slodkowska E, Yang W, Tan PH. Dataset for reporting of the invasive carcinoma of the breast: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2024; 85:418-436. [PMID: 38719547 DOI: 10.1111/his.15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/27/2024] [Accepted: 03/22/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND AND OBJECTIVES Current national or regional guidelines for the pathology reporting on invasive breast cancer differ in certain aspects, resulting in divergent reporting practice and a lack of comparability of data. Here we report on a new international dataset for the pathology reporting of resection specimens with invasive cancer of the breast. The dataset was produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter-)national pathology and cancer organizations. METHODS AND RESULTS The established ICCR process for dataset development was followed. An international expert panel consisting of breast pathologists, a surgeon, and an oncologist prepared a draft set of core and noncore data items based on a critical review and discussion of current evidence. Commentary was provided for each data item to explain the rationale for selecting it as a core or noncore element, its clinical relevance, and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. Following international public consultation, the document was finalized and ratified, and the dataset, which includes a synoptic reporting guide, was published on the ICCR website. CONCLUSIONS This first international dataset for invasive cancer of the breast is intended to promote high-quality, standardized pathology reporting. Its widespread adoption will improve consistency of reporting, facilitate multidisciplinary communication, and enhance comparability of data, all of which will help to improve the management of invasive breast cancer patients.
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Affiliation(s)
- Ian Ellis
- Department of Histopathology, Nottingham City Hospital, London, UK
| | - Fleur Webster
- International Collaboration on Cancer Reporting, Surry Hills, NSW, Australia
| | - Kimberly H Allison
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Chau Dang
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - Helenice Gobbi
- Institute of Health Sciences, Federal University Triangulo Mineiro, Uberaba, Brazil
| | - Janina Kulka
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Sunil R Lakhani
- Centre for Clinical Research and Pathology Queensland, University of Queensland, Brisbane, Australia
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Okayama, Japan
| | - Cecily M Quinn
- Department of Histopathology, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Turin, Italy
- Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Italy
| | - Stuart Schnitt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Elzbieta Slodkowska
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Puay H Tan
- Luma Medical Centre, Royal Square, Singapore, Singapore
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2
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Lucocq J, Haugk B, Joseph N, Hawkyard J, White S, Mownah O, Menon K, Furukawa T, Inoue Y, Hirose Y, Sasahira N, Mittal A, Samra J, Sheen A, Feretis M, Balakrishnan A, Ceresa C, Davidson B, Pande R, Dasari BVM, Tanno L, Karavias D, Helliwell J, Young A, Nunes Q, Urbonas T, Silva M, Gordon-Weeks A, Barrie J, Gomez D, van Laarhoven S, Nawara H, Doyle J, Bhogal R, Harrison E, Roalso M, Zaharia C, Ciprani D, Aroori S, Ratnayake B, Koea J, Capurso G, Bellotti R, Stättner S, Alsaoudi T, Bhardwaj N, Jeffery F, Connor S, Cameron A, Jamieson N, Roberts K, Soreide K, Gill AJ, Pandanaboyana S. Invasive intraductal oncocytic papillary neoplasms (IOPN) and adenocarcimoma arising from intraductal papillary mucinous neoplasms (A-IPMN) of the pancreas: comparative analysis of clinicopathological features, patterns of recurrence and survival: a multicentre study. HPB (Oxford) 2024:S1365-182X(24)02222-6. [PMID: 39084948 DOI: 10.1016/j.hpb.2024.07.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/07/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Intraductal oncocytic papillary neoplasms (IOPNs) of the pancreas are now considered a separate entity to intraductal papillary mucinous neoplasms (IPMN). Invasive IOPNs are extremely rare, and their recurrence patterns, response to adjuvant chemotherapy and long-term survival outcomes are unknown. METHODS Consecutive patients undergoing pancreatic resection (2010-2020) for invasive IOPNs or adenocarcinoma arising from IPMN (A-IPMN) from 18 academic pancreatic centers worldwide were included. Outcomes of invasive IOPNs were compared with A-IPMN invasive subtypes (ductal and colloid A-IPMN). RESULTS 415 patients were included: 20 invasive IOPN, 331 ductal A-IPMN and 64 colloid A-IPMN. After a median follow-up of 6-years, 45% and 60% of invasive IOPNs had developed recurrence and died, respectively. There was no significant difference in recurrence or overall survival between invasive IOPN and ductal A-IPMN. Overall survival of invasive IOPNs was inferior to colloid A-IPMNs (median time of survival 24.4 months vs. 86.7, months, p = 0.013), but the difference in recurrence only showed borderline significance (median time to recurrence, 22.5 months vs. 78.5 months, p = 0.132). Adjuvant chemotherapy, after accounting for high-risk features, did not reduce rates of recurrence in invasive IOPN (p = 0.443), ductal carcinoma (p = 0.192) or colloid carcinoma (p = 0.574). CONCLUSIONS Invasive IOPNs should be considered an aggressive cancer with a recurrence rate and prognosis consistent with ductal type A-IPMN.
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Affiliation(s)
| | - Beate Haugk
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Nejo Joseph
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Jake Hawkyard
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Steve White
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Omar Mownah
- Department of Hepatobiliary & Pancreatic Surgery, King's College Hospital, Denmark Hill, London, UK
| | - Krishna Menon
- Department of Hepatobiliary & Pancreatic Surgery, King's College Hospital, Denmark Hill, London, UK
| | - Takaki Furukawa
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | - Yosuke Inoue
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | - Yuki Hirose
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | - Naoki Sasahira
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan
| | | | - Jas Samra
- Royal North Shore Hospital, Sydney, NSW, Australia
| | - Amy Sheen
- New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Michael Feretis
- Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Anita Balakrishnan
- Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Carlo Ceresa
- Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK
| | - Brian Davidson
- Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK
| | - Rupaly Pande
- Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK
| | - Bobby V M Dasari
- Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK
| | - Lulu Tanno
- Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK
| | - Dimitrios Karavias
- Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK
| | - Jack Helliwell
- Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alistair Young
- Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Quentin Nunes
- Department of Hepatopancreatobiliary Surgery, East Lancashire Teaching Hospitals NHS Trust, UK
| | - Tomas Urbonas
- Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Michael Silva
- Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Alex Gordon-Weeks
- Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Jenifer Barrie
- Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK
| | - Dhanny Gomez
- Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK
| | - Stijn van Laarhoven
- Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Bristol & Weston NHS Foundation Trust, UK
| | - Hossam Nawara
- Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Bristol & Weston NHS Foundation Trust, UK
| | - Joseph Doyle
- Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Ricky Bhogal
- Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Ewen Harrison
- Department of Clinical Surgery, University of Edinburgh, UK
| | - Marcus Roalso
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway
| | - Claudia Zaharia
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway
| | - Debora Ciprani
- Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Somaiah Aroori
- Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Bathiya Ratnayake
- Hepato-pancreatico-biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, New Zealand
| | - Jonathan Koea
- Hepato-pancreatico-biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, New Zealand
| | - Gabriele Capurso
- Pancreatico-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
| | - Ruben Bellotti
- Department of Visceral, Transplant and Thoracic Surgery, Centre of Operative Medicine, Medical University of Innsbrusk, 6020 Innsbruck, Austria
| | - Stefan Stättner
- Department of Visceral, Transplant and Thoracic Surgery, Centre of Operative Medicine, Medical University of Innsbrusk, 6020 Innsbruck, Austria
| | - Tareq Alsaoudi
- Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK
| | - Neil Bhardwaj
- Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK
| | - Fraser Jeffery
- Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, New Zealand
| | - Saxon Connor
- Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, New Zealand
| | - Andrew Cameron
- Wolfson Wohl Cancer Research Centre, Research Institute of Cancer Sciences, University of Glasgow, UK
| | - Nigel Jamieson
- Wolfson Wohl Cancer Research Centre, Research Institute of Cancer Sciences, University of Glasgow, UK
| | - Keith Roberts
- Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK
| | - Kjetil Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway
| | - Anthony J Gill
- Royal North Shore Hospital, Sydney, NSW, Australia; New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Sanjay Pandanaboyana
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
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3
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Klebe S, Judge M, Brcic L, Dacic S, Galateau-Salle F, Nicholson AG, Roggli V, Nowak AK, Cooper WA. Mesothelioma in the pleura, pericardium and peritoneum: Recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2024; 84:633-645. [PMID: 38044849 DOI: 10.1111/his.15106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 12/05/2023]
Abstract
AIMS Mesothelioma is a rare malignancy of the serosal membranes that is commonly related to exposure to asbestos. Despite extensive research and clinical trials, prognosis to date remains poor. Consistent, comprehensive and reproducible pathology reporting form the basis of all future interventions for an individual patient, but also ensures that meaningful data are collected to identify predictive and prognostic markers. METHODS AND RESULTS This article details the International Collaboration on Cancer Reporting (ICCR) process and the development of the international consensus mesothelioma reporting data set. It describes the 'core' and 'non-core' elements to be included in pathology reports for mesothelioma of all sites, inclusive of clinical, macroscopic, microscopic and ancillary testing considerations. An international expert panel consisting of pathologists and a medical oncologist produced a set of data items for biopsy and resection specimens based on a critical review and discussion of current evidence, and in light of the changes in the 2021 WHO Classification of Tumours. The commentary focuses particularly upon new entities such as mesothelioma in situ and provides background on relevant and essential ancillary testing as well as implementation of the new requirement for tumour grading. CONCLUSION We recommend widespread and consistent implementation of this data set, which will facilitate accurate reporting and enhance the consistency of data collection, improve the comparison of epidemiological data, support retrospective research and ultimately help to improve clinical outcomes. To this end, all data sets are freely available worldwide on the ICCR website (www.iccr-cancer.org/data-sets).
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Affiliation(s)
- Sonja Klebe
- Department of Anatomical Pathology, Flinders University and SA Pathology, Adelaide, SA, Australia
| | - Meagan Judge
- International Collaboration on Cancer Reporting, Sydney, NSW, Australia
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Sanja Dacic
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Andrew G Nicholson
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Victor Roggli
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Anna K Nowak
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Wendy A Cooper
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW, Australia
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4
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Badgery HE, Muhlen-Schulte T, Zalcberg JR, D'souza B, Gerstenmaier JF, Pickett C, Samra J, Croagh D. Determination of "borderline resectable" pancreatic cancer - A global assessment of 30 shades of grey. HPB (Oxford) 2023; 25:1393-1401. [PMID: 37558564 DOI: 10.1016/j.hpb.2023.07.883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a poor prognosis. Accurate preoperative assessment using computed tomography (CT) to determine resectability is crucial in ensuring patients are offered the most appropriate therapeutic strategy. Despite the use of classification guidelines, any interobserver variability between reviewing surgeons and radiologists may confound decisions influencing patient treatment pathways. METHODS In this multicentre observational study, an international group of 96 clinicians (42 hepatopancreatobiliary surgeons and 54 radiologists) were surveyed and asked to report 30 pancreatic CT scans of pancreatic cancer deemed borderline at respective multidisciplinary meetings (MDM). The degree of interobserver agreement in resectability among radiologists and surgeons was assessed and subgroup regression analysis was performed. RESULTS Interobserver variability between reviewers was high with no unanimous agreement. Overall interobserver agreement was fair with a kappa value of 0.32 with a higher rate of agreement among radiologists over surgeons. CONCLUSION Interobserver variability among radiologists and surgeons globally is high, calling into question the consistency of clinical decision making for patients with PDAC and suggesting that central review may be required for studies of neoadjuvant or adjuvant approaches in future as well as ongoing quality control initiatives, even amongst experts in the field.
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Affiliation(s)
- Henry E Badgery
- Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Surgery, The University of Melbourne, St Vincent's Hospital, Melbourne, Australia
| | - Tjuntu Muhlen-Schulte
- Cancer Research Program, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia
| | - John R Zalcberg
- Cancer Research Program, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia; Department of Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Bianka D'souza
- Cancer Research Program, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia
| | | | - Craig Pickett
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Jaswinder Samra
- Department of Upper GI Surgery, Royal North Shore Hospital, NSW, Australia
| | - Daniel Croagh
- Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia.
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5
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Augustinus S, Schafrat PJM, Janssen BV, Bonsing BA, Brosens LAA, Busch OR, Crobach S, Doukas M, van Eijck CH, van der Geest LGM, Groot Koerkamp B, de Hingh IHJT, Raicu GM, van Santvoort HC, van Velthuysen ML, Verheij J, Besselink MG, Farina Sarasqueta A. Nationwide Impact of Centralization, Neoadjuvant Therapy, Minimally Invasive Surgery, and Standardized Pathology Reporting on R0 Resection and Overall Survival in Pancreatoduodenectomy for Pancreatic Cancer. Ann Surg Oncol 2023; 30:5051-5060. [PMID: 37210448 PMCID: PMC10319672 DOI: 10.1245/s10434-023-13465-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/22/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Surgeons aim for R0 resection in patients with pancreatic cancer to improve overall survival. However, it is unclear whether recent changes in pancreatic cancer care such as centralization, increased use of neoadjuvant therapy, minimally invasive surgery, and standardized pathology reporting have influenced R0 resections and whether R0 resection remains associated with overall survival. METHODS This nationwide retrospective cohort study included consecutive patients after pancreatoduodenectomy (PD) for pancreatic cancer from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Database (2009-2019). R0 resection was defined as > 1 mm tumor clearance at the pancreatic, posterior, and vascular resection margins. Completeness of pathology reporting was scored on the basis of six elements: histological diagnosis, tumor origin, radicality, tumor size, extent of invasion, and lymph node examination. RESULTS Among 2955 patients after PD for pancreatic cancer, the R0 resection rate was 49%. The R0 resection rate decreased from 68 to 43% (2009-2019, P < 0.001). The extent of resections in high-volume hospitals, minimally invasive surgery, neoadjuvant therapy, and complete pathology reports all significantly increased over time. Only complete pathology reporting was independently associated with lower R0 rates (OR 0.76, 95% CI 0.69-0.83, P < 0.001). Higher hospital volume, neoadjuvant therapy, and minimally invasive surgery were not associated with R0. R0 resection remained independently associated with improved overall survival (HR 0.72, 95% CI 0.66-0.79, P < 0.001), as well as in the 214 patients after neoadjuvant treatment (HR 0.61, 95% CI 0.42-0.87, P = 0.007). CONCLUSIONS The nationwide rate of R0 resections after PD for pancreatic cancer decreased over time, mostly related to more complete pathology reporting. R0 resection remained associated with overall survival.
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Affiliation(s)
- Simone Augustinus
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Amsterdam, The Netherlands.
| | - Pascale J M Schafrat
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Boris V Janssen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Bert A Bonsing
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Lodewijk A A Brosens
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Olivier R Busch
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Stijn Crobach
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michail Doukas
- Department of Pathology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Casper H van Eijck
- Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Lydia G M van der Geest
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - G Mihaela Raicu
- Department of Pathology, St Antonius Hospital and Pathology DNA, Nieuwegein, The Netherlands
| | - Hjalmar C van Santvoort
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht & St. Antonius Hospital Nieuwegein, Utrecht, The Netherlands
| | | | - Joanne Verheij
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Amsterdam, The Netherlands.
| | - Arantza Farina Sarasqueta
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Amsterdam, The Netherlands.
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6
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Dei Tos AP, Webster F, Agaimy A, Bovée J, Dickson B, Doyle L, Dry S, Gronchi A, Hameed M, Hemmings C, Liegl-Atzwanger B, Thway K, Wagner AJ, Wang J, Yoshida A, Fletcher C. Datasets for reporting of soft-tissue sarcoma: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2023; 82:745-754. [PMID: 36631406 DOI: 10.1111/his.14862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/13/2023]
Abstract
AIMS Soft-tissue tumours are rare and both accurate diagnosis and proper treatment represent a global challenge. Current treatment guidelines also recommend review by specialised pathologists. Here we report on international consensus-based datasets for the pathology reporting of biopsy and resection specimens of soft-tissue sarcomas. The datasets were produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of international pathology and cancer organisations. METHODS AND RESULTS According to the ICCR's guidelines for dataset development, an international expert panel consisting of pathologists, a surgical oncologist, and a medical oncologist produced a set of core and noncore data items for biopsy and resection specimens based on a critical review and discussion of current evidence. All professionals involved were subspecialised soft-tissue sarcoma experts and affiliated with tertiary referral centres. Commentary was provided for each data item to explain the rationale for selecting it as a core or noncore element, its clinical relevance, and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. Following international public consultation, the documents were finalised and ratified, and the datasets, which included a synoptic reporting guide, were published on the ICCR website. CONCLUSION These first international datasets for soft-tissue sarcomas are aimed to promote high-quality, standardised pathology reporting. Their adoption will improve consistency of reporting, facilitate multidisciplinary communication, and enhance comparability of data, all of which will help to improve patient's management.
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Affiliation(s)
- Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy.,Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Fleur Webster
- International Collaboration on Cancer Reporting, Sydney, NSW, Australia
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Judith Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Brendan Dickson
- Department of Pathology & Laboratory Medicine, Mount Sinai Hospital and Department of Pathobiology & Laboratory Medicine, University of Toronto, Toronto, ON, Canada
| | - Leona Doyle
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sarah Dry
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Meera Hameed
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chris Hemmings
- Department of Anatomic Pathology, Canterbury Health Laboratories, Christchurch, New Zealand.,Department of Pathology and Biomedical Science, University of Otago Medical School, Christchurch, New Zealand
| | - Bernadette Liegl-Atzwanger
- Diagnostic and Research Institute of Pathology, Comprehensive Cancer Centre Graz, Medical University of Graz, Graz, Austria
| | - Khin Thway
- The Royal Marsden NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Andrew J Wagner
- Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jian Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - Christopher Fletcher
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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7
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Aaquist T, Fristrup CW, Hasselby JP, Hamilton-Dutoit S, Eld M, Pfeiffer P, Mortensen MB, Detlefsen S. Prognostic significance of margin clearance in pancreaticoduodenectomy specimens with pancreatic ductal adenocarcinoma in a Danish population-based nationwide study. HPB (Oxford) 2023:S1365-182X(23)00102-8. [PMID: 37173163 DOI: 10.1016/j.hpb.2023.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND In this nationwide population-based cohort study, we investigated the overall minimum margin width that is independently associated with improved survival following pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) and evaluated whether certain margins or surfaces hold independent prognostic significance. METHODS Data from 367 patients who underwent PD for PDAC in the period 2015-2019 were retrieved from the Danish Pancreatic Cancer Database. Missing data were obtained by review of pathology reports and re-microscopy of resection specimens. Surgical specimens were evaluated using a standardised pathological protocol involving multicolour inking, axial slicing and exact reporting of circumferential margin clearances in 0.5 mm increments. RESULTS When categorised according to margin widths of <0.5, <1.0, <1.5, <2.0, <2.5 and <3.0 mm, R1 resections were detected in 34%, 57%, 75%, 78%, 86% and 87% of cases, respectively. In multivariable analyses, an overall margin clearance of ≥1.5 mm was associated with improved survival compared with a clearance of <1.5 mm (HR 0.70 95% CI 0.51-0.97 (p = 0.031)). When evaluating the margins separately, no margin had independent prognostic significance. CONCLUSION Margin clearance of at least 1.5 mm was independently associated with improved survival following PD for PDAC.
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Affiliation(s)
- Trine Aaquist
- Department of Pathology, Odense University Hospital, Odense, Denmark; Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Odense Patient Data Exploratory Network - OPEN, Odense University Hospital, Odense, Denmark
| | - Claus W Fristrup
- Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Odense Patient Data Exploratory Network - OPEN, Odense University Hospital, Odense, Denmark; Department of Surgery, Odense University Hospital, Odense, Denmark
| | - Jane P Hasselby
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Mikkel Eld
- Department of Pathology, Aalborg University Hospital, Aalborg, Denmark
| | - Per Pfeiffer
- Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Michael B Mortensen
- Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Surgery, Odense University Hospital, Odense, Denmark
| | - Sönke Detlefsen
- Department of Pathology, Odense University Hospital, Odense, Denmark; Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Odense Patient Data Exploratory Network - OPEN, Odense University Hospital, Odense, Denmark.
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8
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Bovée JVMG, Webster F, Amary F, Baumhoer D, Bloem JLH, Bridge JA, Cates JMM, de Alava E, Dei Tos AP, Jones KB, Mahar A, Nielsen GP, Righi A, Wagner AJ, Yoshida A, Fletcher CDM. Datasets for the reporting of primary tumour in bone: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2023; 82:531-540. [PMID: 36464647 PMCID: PMC10107487 DOI: 10.1111/his.14849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Bone tumours are relatively rare and, as a consequence, treatment in a centre with expertise is required. Current treatment guidelines also recommend review by a specialised pathologist. Here we report on international consensus-based datasets for the pathology reporting of biopsy and resection specimens of bone sarcomas. The datasets were produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter-)national pathology and cancer organisations. METHODS AND RESULTS According to the ICCR's process for dataset development, an international expert panel consisting of pathologists, an oncologic orthopaedic surgeon, a medical oncologist, and a radiologist produced a set of core and noncore data items for biopsy and resection specimens based on a critical review and discussion of current evidence. All professionals involved were bone tumour experts affiliated with tertiary referral centres. Commentary was provided for each data item to explain the rationale for selecting it as a core or noncore element, its clinical relevance, and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. Following international public consultation, the documents were finalised and ratified, and the datasets, including a synoptic reporting guide, were published on the ICCR website. CONCLUSION These first international datasets for bone sarcomas are intended to promote high-quality, standardised pathology reporting. Their widespread adoption will improve the consistency of reporting, facilitate multidisciplinary communication, and enhance comparability of data, all of which will help to improve management of bone sarcoma patients.
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Affiliation(s)
- Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Center for Computational Oncology, LUMC, Leiden, The Netherlands
| | - Fleur Webster
- International Collaboration on Cancer Reporting, Sydney, NSW, Australia
| | - Fernanda Amary
- Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, Greater London, UK.,Cancer Institute, University College London, London, UK
| | - Daniel Baumhoer
- Bone Tumour Reference Centre, Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - J L Hans Bloem
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Julia A Bridge
- Division of Molecular Pathology, ProPath, Dallas, TX, USA.,Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Justin M M Cates
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Enrique de Alava
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital, CSIC, University of Seville, Seville, Spain.,Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, Seville, Spain
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedaliera Universitaria di Padova, Padova, Italy.,Department of Medicine, University of Padua, School of Medicine, Padua, Italy
| | - Kevin B Jones
- Department of Orthopaedics, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Annabelle Mahar
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Andrew J Wagner
- Harvard Medical School, Boston, MA, USA.,Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
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9
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Hornick JL, Webster F, Dei Tos AP, Hemmings C, Miettinen M, Oda Y, Raut CP, Rubin BP, Von Mehren M, Wardelmann E, Fletcher CDM. Dataset for reporting of gastrointestinal stromal tumours: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2023; 82:376-384. [PMID: 36073677 DOI: 10.1111/his.14791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 01/20/2023]
Abstract
Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract and are among the most frequent sarcomas. Accurate diagnosis, classification, and reporting are critical for prognostication and patient management, including selection of appropriate targeted therapy. Here we report on international consensus-based datasets for the pathology reporting of biopsy and resection specimens of GIST. The datasets were produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of major international pathology and cancer organizations. An international expert panel consisting of pathologists, a surgical oncologist, and a medical oncologist produced a set of core and noncore data items for biopsy and resection specimens based on a critical review and discussion of current evidence. All professionals involved were subspecialized soft tissue tumour experts and affiliated with tertiary referral centres. Commentary was provided for each data item to explain its clinical relevance and the rationale for selection as a core or noncore element. Following international public consultation, the datasets, which include synoptic reporting guides, were finalized and ratified, and published on the ICCR website. These first international datasets for GIST are intended to promote high-quality, standardised pathology reporting. Their widespread adoption will improve consistency of reporting, facilitate multidisciplinary communication, and enhance comparability of data, all of which will ultimately help to improve the management of patients with GIST. All the ICCR datasets, including these on GIST, are freely available worldwide on the ICCR website (www.iccr-cancer.org/datasets).
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Affiliation(s)
- Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Fleur Webster
- International Collaboration on Cancer Reporting, Sydney, NSW, Australia
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedaliera Universitaria di Padova, Padova, Italy.,Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Chris Hemmings
- Department of Anatomic Pathology, Canterbury Health Laboratories, Christchurch, New Zealand.,Department of Pathology and Biomedical Science, Christchurch Clinical School, University of Otago School of Medicine, Christchurch, New Zealand
| | - Markku Miettinen
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health Bethesda, Bethesda, MD, USA
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Chandrajit P Raut
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Brian P Rubin
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Margaret Von Mehren
- Department of Hematology and Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Eva Wardelmann
- Gerhard-Domagk-Institute of Pathology, University of Münster, Münster, Germany
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10
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Maleszewski JJ, Basso C, Burke A, Castonguay M, Leduc C, Tavora F, Sheppard M, Suri R, Judge M, Cooper WA. Dataset for the reporting of neoplasms of the heart, pericardium, and great vessels: recommendations from the International Collaboration on Cancer Reporting (ICCR). Virchows Arch 2023; 482:303-309. [PMID: 36512082 DOI: 10.1007/s00428-022-03473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 10/31/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
The International Collaboration on Cancer Reporting (ICCR) was founded by major pathology organizations from around the world to produce internationally standardized and evidence-based datasets for pathologists' reporting of cancer. Its goal is to improve cancer patient outcomes worldwide and to advance international benchmarking in cancer management. The ICCR cancer dataset development schedule is aligned with revisions of the WHO Classification of Tumours ("Blue Book") series, and in 2015 ICCR developed an initial series of thoracic datasets including a dataset for neoplasms of the heart, pericardium, and great vessels. This edition has now been updated to align with the 2021 WHO Blue Book series. An expert panel was convened to review and revise the dataset. While the majority of ICCR datasets are focused on malignant tumors, the scope of this dataset includes a number of benign tumors and tumor-like entities because of the rarity of cardiac malignancies and the serious implications of even histologically benign lesions. Due to the rarity of cardiac tumors, evidence in support of reporting elements is limited.
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Affiliation(s)
- Joseph J Maleszewski
- ICCR Dataset for the Reporting of Neoplasms of the Heart, Pericardium, and Great Vessels Dataset Authoring Committee, Department of Laboratory Medicine & Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
| | - Cristina Basso
- Cardiovascular Pathology, Azienda Ospedaliera, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Allen Burke
- University of Maryland Medical Center, University of Maryland, Baltimore, MD, USA
| | - Mathieu Castonguay
- Department of Pathology, Faculty of Medicine, Dalhousie University Halifax, Halifax, NS, Canada
| | - Charles Leduc
- Department of Pathology, University of Montreal Health Center, Montreal, QC, Canada
| | - Fabio Tavora
- Messejana Heart and Lung Hospital, Fortaleza, Brazil
| | - Mary Sheppard
- St. George's Medical School, University of London, London, UK
| | - Rakesh Suri
- Division of Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Meagan Judge
- Royal College of Pathologists of Australasia, Surry Hills, New South Wales, Australia
| | - Wendy A Cooper
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia.,Discipline of Pathology, School of Medicine, Western Sydney University, Penrith, NSW, Australia
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11
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Pung L, Moorin R, Trevithick R, Taylor K, Chai K, Garcia Gewerc C, Ha N, Smith S. Determining cancer stage at diagnosis in population-based cancer registries: A rapid scoping review. FRONTIERS IN HEALTH SERVICES 2023; 3:1039266. [PMID: 36926511 PMCID: PMC10012750 DOI: 10.3389/frhs.2023.1039266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/03/2023] [Indexed: 03/18/2023]
Abstract
Introduction Population-based cancer registries are the main source of data for population-level analysis of cancer stage at diagnosis. This data enables analysis of cancer burden by stage, evaluation of screening programs and provides insight into differences in cancer outcomes. The lack of standardised collection of cancer staging in Australia is well recognised and is not routinely collected within the Western Australia Cancer Registry. This review aimed to explore how cancer stage at diagnosis is determined in population-based cancer registries. Methods This review was guided by the Joanna-Briggs Institute methodology. A systematic search of peer-reviewed research studies and grey literature from 2000 to 2021 was conducted in December 2021. Literature was included if peer-reviewed articles or grey literature sources used population-based cancer stage at diagnosis, and were published in English between 2000 and 2021. Literature was excluded if they were reviews or only the abstract was available. Database results were screened by title and abstract using Research Screener. Full-texts were screened using Rayyan. Included literature were analysed using thematic analysis and managed through NVivo. Results The findings of the 23 included articles published between 2002 and 2021 consisted of two themes. (1) "Data sources and collection processes" outlines the data sources used, as well as the processes and timing of data collection utilised by population-based cancer registries. (2) "Staging classification systems" reveals the staging classification systems employed or developed for population-based cancer staging, including the American Joint Committee on Cancer's Tumour Node Metastasis and related systems; simplified systems classified into localised, regional, and distant categories; and miscellaneous systems. Conclusions Differences in approaches used to determine population-based cancer stage at diagnosis challenge attempts to make interjurisdictional and international comparisons. Barriers to collecting population-based stage at diagnosis include resource availability, infrastructure differences, methodological complexity, interest variations, and differences in population-based roles and emphases. Even within countries, disparate funding sources and funder interests can challenge the uniformity of population-based cancer registry staging practices. International guidelines to guide cancer registries in collecting population-based cancer stage is needed. A tiered framework of standardising collection is recommended. The results will inform integrating population-based cancer staging into the Western Australian Cancer Registry.
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Affiliation(s)
- Li Pung
- School of Population Health, Curtin University, Perth, WA, Australia.,Public Health, North Metropolitan Health Service, Perth, WA, Australia
| | - Rachael Moorin
- School of Population Health, Curtin University, Perth, WA, Australia.,School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Richard Trevithick
- Department of Health, Western Australia Cancer Registry, Clinical Excellence Division, Perth, WA, Australia
| | - Karen Taylor
- Cancer Network WA, North Metropolitan Health Service, Perth, WA, Australia
| | - Kevin Chai
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | - Ninh Ha
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Stephanie Smith
- School of Population Health, Curtin University, Perth, WA, Australia
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12
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Karbanowicz E, Fuchs TL, Chou A, Sioson L, Sheen A, Ahadi MS, Gill AJ. What are the problems with the current staging of discontinuous tumour nodules (DTNs) in colorectal carcinoma? Is there a better way? Pathology 2022; 54:848-854. [DOI: 10.1016/j.pathol.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 10/14/2022]
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13
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Sohn HJ, Kim H, Kim SJ, Lee KB, Han Y, Lee JM, Kang JS, Kwon W, Chie EK, Kim H, Jang JY. Oncologic outcomes according to the location and status of resection margin in pancreas head cancer: role of radiation therapy in R1 resection. Ann Surg Treat Res 2022; 102:10-19. [PMID: 35071115 PMCID: PMC8753382 DOI: 10.4174/astr.2022.102.1.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/13/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose The clinical significance of margin status in pancreatic head cancer is still controversial due to the nonstandardized definition of R status and pathologic reporting. This study aims to evaluate the impact of the margin status including location and the role of radiation therapy in pancreatic head cancer. Methods A total of 314 patients who underwent curative-intent surgery for pancreatic head cancer between 2010 and 2017 were analyzed. Demographics, survival, and local recurrences were compared according to 2 definitions: 0-mm R1 as direct involvement and 1-mm R1 as close resection margin less than 1 mm. The specific margins were divided into 4 groups according to the location around the pancreas: pancreas transection, anterior surface, posterior surface, and vessel (superior mesenteric artery/superior mesenteric vein) margin. Results The 0-mm R1-rate was 15.6%, and increased to 36.3% in 1-mm R1. The median overall survival rate of 0-mm R0 vs. R1 was 26 months vs. 16 months (P = 0.052) and that of 1-mm R0 vs. R1 was 27 months vs. 18 months, respectively (P = 0.016). In individual margins, posterior, anterior surface, and pancreas transection margin involvement were associated with poor outcome, and the 1 mm posterior surface involvement was an independent risk factor for disease-free survival (hazard ratio, 1.63). Adjuvant radiation therapy had oncologic benefits, especially in R1 patients (P = 0.011) compared to R0 patients (P = 0.088). Conclusion Margin status, especially 1-mm R1 status is an important predictive factor, and involved posterior surface has a clinical impact. Patients with positive margins should be considered adjuvant radiation therapy.
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Affiliation(s)
- Hee Ju Sohn
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Joo Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Bun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Seung Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Eui Kyu Chie
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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14
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Henkel M, Mertz KD, Laux J, Klan M, Breit C, Marston K, Matthias MO, Dugas SG, Manneck S, Stieltjes B, Seifert H, Wetterauer C. Toward a Platform for Structured Data Acquisition in Oncology: A Pilot Study on Prostate Cancer Screening. Oncology 2021; 99:802-812. [PMID: 34515209 DOI: 10.1159/000518381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/25/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Physicians spend an ever-rising amount of time to collect relevant information from highly variable medical reports and integrate them into the patient's health condition. OBJECTIVES We compared synoptic reporting based on data elements to narrative reporting in order to evaluate its capabilities to collect and integrate clinical information. METHODS We developed a novel system to align medical reporting to data integration requirements and tested it in prostate cancer screening. We compared expenditure of time, data quality, and user satisfaction for data acquisition, integration, and evaluation. RESULTS In a total of 26 sessions, 2 urologists, 2 radiologists, and 2 pathologists conducted the diagnostic work-up for prostate cancer screening with both narrative reporting and the novel system. The novel system led to a significantly reduced time for collection and integration of patient information (91%, p < 0.001), reporting in radiology (44%, p < 0.001) and pathology (33%, p = 0.154). The system usage showed a high positive effect on evaluated data quality parameters completeness, format, understandability, as well as user satisfaction. CONCLUSION This study provides evidence that synoptic reporting based on data elements is effectively reducing time for collection and integration of patient information. Further research is needed to assess the system's impact for different patient journeys.
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Affiliation(s)
- Maurice Henkel
- Research & Analytic Services University Hospital Basel, Basel, Switzerland, .,Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland, .,Institute of Radiology, University Hospital Basel, Basel, Switzerland,
| | - Kirsten D Mertz
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
| | - Jonas Laux
- Research & Analytic Services University Hospital Basel, Basel, Switzerland
| | - Matthias Klan
- Research & Analytic Services University Hospital Basel, Basel, Switzerland
| | - Christian Breit
- Institute of Radiology, University Hospital Basel, Basel, Switzerland
| | - Katharina Marston
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Marc O Matthias
- Institute of Urology, University Hospital Basel, Basel, Switzerland
| | - Sarah G Dugas
- Institute of Urology, University Hospital Basel, Basel, Switzerland
| | - Sebastian Manneck
- Institute of Radiology, University Hospital Basel, Basel, Switzerland
| | - Bram Stieltjes
- Research & Analytic Services University Hospital Basel, Basel, Switzerland.,Institute of Radiology, University Hospital Basel, Basel, Switzerland
| | - Helge Seifert
- Institute of Urology, University Hospital Basel, Basel, Switzerland
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15
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Verbeke C, Webster F, Brosens L, Campbell F, Del Chiaro M, Esposito I, Feakins RM, Fukushima N, Gill AJ, Kakar S, Kench JG, Krasinskas AM, van Laethem JL, Schaeffer DF, Washington K. Dataset for the reporting of carcinoma of the exocrine pancreas: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2021; 79:902-912. [PMID: 34379823 DOI: 10.1111/his.14540] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Current guidelines for the pathology reporting on pancreatic cancer differ in certain aspects, resulting in divergent reporting practice and a lack of comparability of data. Here we report on a new international dataset for the pathology reporting of resection specimens with cancer of the exocrine pancreas (ductal adenocarcinoma and acinar cell carcinoma). The dataset was produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter-)national pathology and cancer organisations. METHODS AND RESULTS According to the ICCR's rigorous process for dataset development, an international expert panel consisting of pancreatic pathologists, a pancreatic surgeon and an oncologist produced a set of core and non-core data items based on a critical review and discussion of current evidence. Commentary was provided for each data item to explain the rationale for selecting it as a core or non-core element, its clinical relevance, and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. Following international public consultation, the document was finalised and ratified, and the dataset, which includes a synoptic reporting guide, was published on the ICCR website. CONCLUSIONS This first international dataset for cancer of the exocrine pancreas is intended to promote high quality, standardised pathology reporting. Its widespread adoption will improve consistency of reporting, facilitate multidisciplinary communication and enhance comparability of data, all of which will help to improve the management of pancreatic cancer patients.
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Affiliation(s)
- Caroline Verbeke
- Department of Pathology, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Fleur Webster
- International Collaboration on Cancer Reporting, Sydney, Australia
| | - Lodewijk Brosens
- Department of Pathology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands and Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Fiona Campbell
- Department of Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Marco Del Chiaro
- Department of Surgery, University of Colorado Denver - Anschutz Medical Campus, Aurora, 80045, Colorado, United States
| | - Irene Esposito
- Institute of Pathology, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Roger M Feakins
- Department of Histopathology, Royal Free Hospital, London, United Kingdom
| | | | - Anthony J Gill
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, Australia.,NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, Australia
| | - Sanjay Kakar
- Department of Pathology, University of California, M590 San Francisco, United States
| | - James G Kench
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, New South Wales Health Pathology, Camperdown, Australia
| | - Alyssa M Krasinskas
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, United States
| | - Jean-Luc van Laethem
- Department of Gastroenterology and Medical Oncology, Hôpital Erasme and Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium
| | - David F Schaeffer
- Division of Anatomic Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kay Washington
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Centre, Nashville, Tennessee, United States
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16
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[Standardized diagnosis of pancreatic head carcinoma]. DER PATHOLOGE 2021; 42:453-463. [PMID: 34357472 DOI: 10.1007/s00292-021-00971-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
Most pancreatic ductal adenocarcinomas are localized in the pancreatic head. Due to the complex anatomic relationships with the surrounding organs and vascular structures in the retroperitoneal space and to the presence of numerous transection margins and dissection planes, pancreatic head resections belong to the most complex specimens concerning grossing and sampling for histopathologic analysis.Here we discuss current guidelines for standardized grossing and reporting of pancreatic cancer, with special reference to the assessment of the resection margin status. The importance of standardized reporting for the sake of completeness, comprehensibility, comparability, and quality control as well as for the integration of pathology reports in interdisciplinary digital workflows and artificial intelligence applications will be emphasized.
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17
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Zhang B, Lee GC, Qadan M, Fong ZV, Mino-Kenudson M, Desphande V, Malleo G, Maggino L, Marchegiani G, Salvia R, Scarpa A, Luchini C, De Gregorio L, Ferrone CR, Warshaw AL, Lillemoe KD, Bassi C, Castillo CFD. Revision of Pancreatic Neck Margins Based on Intraoperative Frozen Section Analysis Is Associated With Improved Survival in Patients Undergoing Pancreatectomy for Ductal Adenocarcinoma. Ann Surg 2021; 274:e134-e142. [PMID: 31851002 DOI: 10.1097/sla.0000000000003503] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To test the hypothesis that complete, tumor-free resection at the pancreatic neck, achieved either en-bloc or non-en-bloc (ie, revision based on intraoperative frozen section [FS] analysis), is associated with improved survival as compared with incomplete resection (IR) in pancreatic ductal adenocarcinoma. SUMMARY BACKGROUND DATA Given the likely systemic nature of pancreatic ductal adenocarcinoma, the oncologic benefit of achieving a histologically complete local resection, particularly through revision of a positive intraoperative FS at the pancreatic neck, remains controversial. METHODS Clinicopathologic and treatment data were reviewed for 986 consecutive patients with ductal adenocarcinoma at the head, neck, or uncinate process of the pancreas who underwent open pancreatectomy as well as intraoperative FS analysis between 1998 and 2012 at Massachusetts General Hospital and between 1998 and 2013 at the University of Verona. Overall survival (OS) and perioperative morbidity and mortality were compared across 3 groups: complete resection achieved en-bloc (CR-EB), complete resection achieved non-en-bloc (CR-NEB), and IR. RESULTS The CR-EB cohort comprised 749 (76%) patients, CR-NEB 159 patients (16%), and IR 78 patients (8%). Other than a higher incidence of vascular resection among CR-NEB and IR patients, no demographic, pathologic (eg, tumor grade, lymph node positivity, superior mesenteric artery involvement), or treatment factors (eg, neoadjuvant and adjuvant therapy use) differed between the groups. Median OS was significantly higher in patients with CR-EB (28 mo, P = 0.01) and CR-NEB resections (24 mo, P = 0.02) as compared with patients with IR resections (19 mo). After adjusting for clinicopathologic and treatment characteristics, CR-EB and CR-NEB margin status were found to be independent predictors of improved OS (relative to IR, CR-EB hazard ratio [HR] 0.65, 95% confidence interval [CI] 0.49-0.86; CR-NEB HR 0.69, 95% CI 0.50-0.96). There were no intergroup differences in perioperative morbidity and mortality, including rates of pancreatic fistula. CONCLUSIONS For patients with ductal adenocarcinoma at the head, neck, or uncinate process of the pancreas undergoing pancreatectomy, complete tumor extirpation via either en-bloc or non-en-bloc complete resection based on FS analysis is associated with improved OS, without an associated increased perioperative morbidity or mortality.
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Affiliation(s)
- Biqi Zhang
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Grace C Lee
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Zhi Ven Fong
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Vikram Desphande
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Giuseppe Malleo
- Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital of Verona Hospital Trust, Verona, Italy
| | - Laura Maggino
- Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital of Verona Hospital Trust, Verona, Italy
| | - Giovanni Marchegiani
- Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital of Verona Hospital Trust, Verona, Italy
| | - Roberto Salvia
- Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital of Verona Hospital Trust, Verona, Italy
| | - Aldo Scarpa
- Applied Research on Cancer Centre (ARC-Net), University and Hospital Trust of Verona, Verona, Italy
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Lucia De Gregorio
- Multi-Organ Transplant Institute, Ochsner Clinic Foundation, New Orleans, LA
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Andrew L Warshaw
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Keith D Lillemoe
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Claudio Bassi
- Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital of Verona Hospital Trust, Verona, Italy
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18
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Meuten DJ, Moore FM, Donovan TA, Bertram CA, Klopfleisch R, Foster RA, Smedley RC, Dark MJ, Milovancev M, Stromberg P, Williams BH, Aubreville M, Avallone G, Bolfa P, Cullen J, Dennis MM, Goldschmidt M, Luong R, Miller AD, Miller MA, Munday JS, Roccabianca P, Salas EN, Schulman FY, Laufer-Amorim R, Asakawa MG, Craig L, Dervisis N, Esplin DG, George JW, Hauck M, Kagawa Y, Kiupel M, Linder K, Meichner K, Marconato L, Oblak ML, Santos RL, Simpson RM, Tvedten H, Whitley D. International Guidelines for Veterinary Tumor Pathology: A Call to Action. Vet Pathol 2021; 58:766-794. [PMID: 34282984 DOI: 10.1177/03009858211013712] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Standardization of tumor assessment lays the foundation for validation of grading systems, permits reproducibility of oncologic studies among investigators, and increases confidence in the significance of study results. Currently, there is minimal methodological standardization for assessing tumors in veterinary medicine, with few attempts to validate published protocols and grading schemes. The current article attempts to address these shortcomings by providing standard guidelines for tumor assessment parameters and protocols for evaluating specific tumor types. More detailed information is available in the Supplemental Files, the intention of which is 2-fold: publication as part of this commentary, but more importantly, these will be available as "living documents" on a website (www.vetcancerprotocols.org), which will be updated as new information is presented in the peer-reviewed literature. Our hope is that veterinary pathologists will agree that this initiative is needed, and will contribute to and utilize this information for routine diagnostic work and oncologic studies. Journal editors and reviewers can utilize checklists to ensure publications include sufficient detail and standardized methods of tumor assessment. To maintain the relevance of the guidelines and protocols, it is critical that the information is periodically updated and revised as new studies are published and validated with the intent of providing a repository of this information. Our hope is that this initiative (a continuation of efforts published in this journal in 2011) will facilitate collaboration and reproducibility between pathologists and institutions, increase case numbers, and strengthen clinical research findings, thus ensuring continued progress in veterinary oncologic pathology and improving patient care.
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Affiliation(s)
| | | | | | - Christof A Bertram
- Freie Universität Berlin, Berlin, Germany.,University of Veterinary Medicine, Vienna, Austria
| | | | | | | | | | | | | | | | | | | | - Pompei Bolfa
- Ross University, Basseterre, Saint Kitts and Nevis
| | - John Cullen
- North Carolina State University, Raleigh, NC, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Nick Dervisis
- VA-MD College of Veterinary Medicine, Blacksburg, VA, USA
| | | | | | | | | | | | - Keith Linder
- North Carolina State University, Raleigh, NC, USA
| | | | | | | | - Renato L Santos
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - R Mark Simpson
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Harold Tvedten
- Swedish University of Agricultural Sciences, Uppsala, Sweden
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19
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A Critical Assessment of Postneoadjuvant Therapy Pancreatic Cancer Regression Grading Schemes With a Proposal for a Novel Approach. Am J Surg Pathol 2021; 45:394-404. [PMID: 33074853 DOI: 10.1097/pas.0000000000001601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Currently, there is no consensus on the optimal tumor response score (TRS) system to assess regression in pancreatic cancers resected after neoadjuvant therapy. We developed a novel TRS (Royal North Shore [RNS] system) based on estimating the percentage of tumor bed occupied by viable cancer and categorized into 3 tiers: grade 1 (≤10%), grade 2 (11% to 75%), and grade 3 (>75%). We assessed 147 resected carcinomas with this and other TRS systems (College of American Pathologists [CAP], MD Anderson Cancer Center [MDACC], and Evans). The 3-tiered RNS system predicted median survival after surgery for grades 1, 2, and 3 of 54, 23, and 9 months, respectively (P<0.05). The CAP, MDACC, and Evans systems also predicted survival (P<0.05) but less consistently. The median survival for MDACC and CAP grade 0 (complete regression) was less than MDACC grade 1 and CAP grades 1 and 2. There was no difference in survival between CAP grades 2 and 3 (P=0.960), Evans grades 1 and 2a (P=0.395), and Evans grades 2a and 2b (P=0.587). Interobserver concordance was weak for CAP (κ=0.431), moderate for MDACC (κ=0.691), minimal for Evans (κ=0.307), and moderate to strong for RNS (κ=0.632 to 0.84). Of age, sex, size, stage, grade, perineural and vascular invasion, extrapancreatic extension, margin status, and RNS score, only RNS score, vascular invasion, and extrapancreatic extension predicted survival in univariate analysis. Only extrapancreatic extension (P=0.034) and RNS score (P<0.0001) remained significant in multivariate analysis. We conclude that the RNS system is a reproducible and powerful predictor of survival after resection for pancreatic cancers treated with neoadjuvant therapy and should be investigated in larger cohorts.
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20
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Huang Y, Damodaran Prabha R, Chua TC, Arena J, Kotecha K, Mittal A, Gill AJ, Samra JS. Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians. Front Surg 2021; 8:617286. [PMID: 33604352 PMCID: PMC7884922 DOI: 10.3389/fsurg.2021.617286] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Backgrounds: Pancreaticoduodenectomy (PD) remains the only hope of a cure in selected patients with pancreatic adenocarcinoma (PAC). With an aging population, there will be an increasing number of very elderly patients being diagnosed with PAC of whom a selected proportion would be suitable for PD. However, the literature on outcomes of elderly patients after PD remains ambiguous. Therefore, the aim of this study was to examine the safety and efficacy of PD in octogenarians with PAC. Methods: A retrospective analysis of 304 patients with PAC undergoing PD. Patients were divided into two age groups using age of 80 years old as the cut-off. Results: Overall mortality and major morbidity rates were 0.5 and 18.5%, respectively. The octogenarian group had a higher rate of mortality (6.3%, n = 1, p < 0.001), a higher rate of major morbidity (37.5%, n = 6, p = 0.042) and a longer hospital stay (p = 0.035). However, median survival of octogenarians was 15.6 months. Multivariate analysis showed age was not identified as a prognostic factor for major morbidity and overall survival. Conclusion: Age alone should not be an exclusion criterion for consideration of PD. With careful selection, PD can be safely performed in octogenarians. Elderly patients should be referred to a specialized unit for an objective assessment to determine the suitability for this aggressive but potential curative approach.
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Affiliation(s)
- Yeqian Huang
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia.,Northern Clinical School, University of Sydney, Sydney, NSW, Australia.,South Western Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Ramesh Damodaran Prabha
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Terence C Chua
- Department of Surgery, QE II Jubilee Hospital, Metro South Health, Brisbane, QLD, Australia.,School of Medicine, Griffith University, Gold Coast, QLD, Australia.,Discipline of Surgery, The University of Queensland, Brisbane, QLD, Australia
| | - Jennifer Arena
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Krishna Kotecha
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Anubhav Mittal
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Anthony J Gill
- Northern Clinical School, University of Sydney, Sydney, NSW, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, Australia.,Deparment of Anatomical Pathology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Jaswinder S Samra
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia.,Macquarie University Hospital, Macquarie University, Sydney, NSW, Australia
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21
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Zhao Y, Pan Z, Namburi S, Pattison A, Posner A, Balachander S, Paisie CA, Reddi HV, Rueter J, Gill AJ, Fox S, Raghav KPS, Flynn WF, Tothill RW, Li S, Karuturi RKM, George J. CUP-AI-Dx: A tool for inferring cancer tissue of origin and molecular subtype using RNA gene-expression data and artificial intelligence. EBioMedicine 2020; 61:103030. [PMID: 33039710 PMCID: PMC7553237 DOI: 10.1016/j.ebiom.2020.103030] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cancer of unknown primary (CUP), representing approximately 3-5% of all malignancies, is defined as metastatic cancer where a primary site of origin cannot be found despite a standard diagnostic workup. Because knowledge of a patient's primary cancer remains fundamental to their treatment, CUP patients are significantly disadvantaged and most have a poor survival outcome. Developing robust and accessible diagnostic methods for resolving cancer tissue of origin, therefore, has significant value for CUP patients. METHODS We developed an RNA-based classifier called CUP-AI-Dx that utilizes a 1D Inception convolutional neural network (1D-Inception) model to infer a tumor's primary tissue of origin. CUP-AI-Dx was trained using the transcriptional profiles of 18,217 primary tumours representing 32 cancer types from The Cancer Genome Atlas project (TCGA) and International Cancer Genome Consortium (ICGC). Gene expression data was ordered by gene chromosomal coordinates as input to the 1D-CNN model, and the model utilizes multiple convolutional kernels with different configurations simultaneously to improve generality. The model was optimized through extensive hyperparameter tuning, including different max-pooling layers and dropout settings. For 11 tumour types, we also developed a random forest model that can classify the tumour's molecular subtype according to prior TCGA studies. The optimised CUP-AI-Dx tissue of origin classifier was tested on 394 metastatic samples from 11 tumour types from TCGA and 92 formalin-fixed paraffin-embedded (FFPE) samples representing 18 cancer types from two clinical laboratories. The CUP-AI-Dx molecular subtype was also independently tested on independent ovarian and breast cancer microarray datasets FINDINGS: CUP-AI-Dx identifies the primary site with an overall top-1-accuracy of 98.54% in cross-validation and 96.70% on a test dataset. When applied to two independent clinical-grade RNA-seq datasets generated from two different institutes from the US and Australia, our model predicted the primary site with a top-1-accuracy of 86.96% and 72.46% respectively. INTERPRETATION The CUP-AI-Dx predicts tumour primary site and molecular subtype with high accuracy and therefore can be used to assist the diagnostic work-up of cancers of unknown primary or uncertain origin using a common and accessible genomics platform. FUNDING NIH R35 GM133562, NCI P30 CA034196, Victorian Cancer Agency Australia.
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Affiliation(s)
- Yue Zhao
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA
| | - Ziwei Pan
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA; Department of Genetics and Genome Sciences, University of Connecticut Health Center, Farmington, CT, USA
| | - Sandeep Namburi
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA
| | - Andrew Pattison
- Department of Clinical Pathology and Centre for Cancer Research, University of Melbourne, Parkville, Melbourne, Australia
| | - Atara Posner
- Department of Clinical Pathology and Centre for Cancer Research, University of Melbourne, Parkville, Melbourne, Australia
| | - Shiva Balachander
- Department of Clinical Pathology and Centre for Cancer Research, University of Melbourne, Parkville, Melbourne, Australia
| | - Carolyn A Paisie
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA
| | - Honey V Reddi
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA; The Jackson Laboratory Cancer Center, Bar Harbor, ME, USA
| | - Jens Rueter
- The Jackson Laboratory Cancer Center, Bar Harbor, ME, USA
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales 2065 Australia; NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales 2065 Australia; Department of Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park, New South Wales 2113 Australia; University of Sydney, Sydney, New South Wales 2006 Australia
| | - Stephen Fox
- Peter MacCallum Cancer Centre, Department of Pathology, University of Melbourne, Victoria, Australia
| | - Kanwal P S Raghav
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William F Flynn
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA
| | - Richard W Tothill
- Department of Clinical Pathology and Centre for Cancer Research, University of Melbourne, Parkville, Melbourne, Australia; Peter MacCallum Cancer Centre, Parkville, Melbourne, Australia.
| | - Sheng Li
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA; The Jackson Laboratory Cancer Center, Bar Harbor, ME, USA; Department of Genetics and Genome Sciences, University of Connecticut Health Center, Farmington, CT, USA; Department of Computer Science and Engineering, University of Connecticut, Storrs, CT, USA.
| | - R Krishna Murthy Karuturi
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA; The Jackson Laboratory Cancer Center, Bar Harbor, ME, USA; Department of Computer Science and Engineering, University of Connecticut, Storrs, CT, USA.
| | - Joshy George
- The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT, USA; The Jackson Laboratory Cancer Center, Bar Harbor, ME, USA.
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22
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Renshaw AA, Gatcliffe T, Gould EW. Synoptic Report Response Options Directly Impact Patient Care. Arch Pathol Lab Med 2020. [DOI: 10.5858/arpa.2020-0181-le] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Andrew A. Renshaw
- Department of Pathology and Surgery, Baptist Health of South Florida, Miami
| | | | - Edwin W. Gould
- Department of Pathology and Surgery, Baptist Health of South Florida, Miami
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23
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Renshaw AA, Gould EW. In Reply. Arch Pathol Lab Med 2020; 144:273-274. [PMID: 32101055 DOI: 10.5858/arpa.2019-0558-le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Andrew A Renshaw
- Departments of Pathology, Baptist Hospital and Miami Cancer Institute, Miami, Florida
| | - Edwin W Gould
- Departments of Pathology, Baptist Hospital and Miami Cancer Institute, Miami, Florida
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24
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Häberle L, Esposito I. Circumferential resection margin (CRM) in pancreatic cancer. SURGERY IN PRACTICE AND SCIENCE 2020. [DOI: 10.1016/j.sipas.2020.100006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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25
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Di Martino M, Muñoz de Nova JL, Guijarro Rojas M, Alday Muñoz E, Martín-Pérez E. Positive Resection Margins Detected by Standardized Study of a Pancreaticoduodenectomy Sample: Is There Any Real Impact on Long-term Survival? Cir Esp 2019; 98:127-135. [PMID: 31784034 DOI: 10.1016/j.ciresp.2019.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 08/16/2019] [Accepted: 09/09/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The pathological evaluation of pancreaticoduodenectomy (PD) samples and the impact of R1 resections on survival has recently been questioned. This study evaluates the introduction of a standardized pathology study protocol (PSP) and the prognosis of R1 resections after long-term follow-up. METHODS We reviewed data from a prospectively maintained database regarding 109 periampullary tumors treated by PD from 2005 to 2013. The results of the introduction of a PSP were analysed, and the recurrence rate (RR), disease-free survival (DFS) and overall survival (OS) of the R1 resections were evaluated for each positive margin. RESULTS The PD specimens of periampullary tumors analyzed by PSP showed a higher rate of isolated lymph nodes (17 vs. 8; P=.003), N+ (60% vs. 31%; P<.001), microvascular invasion (67% vs. 34%; P=.001) and R1 resections (42% vs. 18%; P=.010). Pancreatic adenocarcinomas with R1 resection in the PSP group were compared with R0, presenting higher percentages of vascular resections (P=.033), N+ (P=.029), lymphatic and perineural invasion (P=.047; P=.029), higher RR (P=.026), lower DFS (P=.016) and lower OS (P=.025). Invasion of the medial margin correlated with a worse prognosis. CONCLUSIONS Our series shows an increase in R1 resection after the introduction of a PSP. Infiltration of the medial margin seems to be associated with a higher RR and a decrease in DFS and OS.
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Affiliation(s)
- Marcello Di Martino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España.
| | - Jose Luis Muñoz de Nova
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | | | - Enrique Alday Muñoz
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Princesa, Madrid, España
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
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Data Set for the Reporting of Carcinoma of the Renal Pelvis and Ureter—Nephroureterectomy and Ureterectomy Specimens. Am J Surg Pathol 2019; 43:e1-e12. [DOI: 10.1097/pas.0000000000001305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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27
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Delahunt B, Srigley JR, Judge M, Amin M, Billis A, Camparo P, Fleming S, Griffiths D, Lopez-Beltran A, Martignoni G, Moch H, Nacey JN, Zhou M, Evans AJ. Dataset for the reporting of renal biopsy for tumour: recommendations from the International Collaboration on Cancer Reporting (ICCR). J Clin Pathol 2019; 72:573-578. [PMID: 31300532 DOI: 10.1136/jclinpath-2019-205959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/06/2019] [Accepted: 06/19/2019] [Indexed: 11/04/2022]
Abstract
The International Collaboration on Cancer Reporting (ICCR) has developed a suite of detailed datasets for international implementation. These datasets are based on the reporting protocols developed by the Royal College of Pathologists (UK), The Royal College of Pathologists of Australasia and the College of American Pathologists, with modifications undertaken by international expert groups appointed according to ICCR protocols. The dataset for the reporting of renal biopsy for tumour is designed to provide a structured reporting template containing minimum data recording key elements suitable for international use. In formulating the dataset, the ICCR panel incorporated recommendations from the 2012 Vancouver Consensus Conference of the International Society of Urological Pathology (ISUP) and the 2016 edition of the WHO Bluebook on tumours of the urinary and male genital systems. Reporting elements were divided into Required (Core) and Recommended (Non-core) components of the report. Required elements are as follows: specimen laterality, histological tumour type, WHO/ISUP histological tumour grade, sarcomatoid morphology, rhabdoid morphology, necrosis, lymphovascular invasion and coexisting pathology in non-neoplastic kidney. Recommended reporting elements are as follows: operative procedure, tumour site(s), histological tumour subtype and details of ancillary studies. In particular, it is noted that fluorescence in situ hybridisation studies may assist in diagnosing translocation renal cell carcinoma (RCC) and in distinguishing oncocytoma and eosinophilic chromophobe RCC. It is anticipated that the implementation of this dataset into routine clinical practice will facilitate uniformity of pathology reporting worldwide. This, in turn, should have a positive impact on patient treatment and the quality of demographic information held by cancer registries.
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Affiliation(s)
- Brett Delahunt
- Department of Pathology and Molecular Medicine, Wellington Sch Med, Wellington, New Zealand
| | - John R Srigley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Meagan Judge
- Royal College of Pathologists of Australasia, Surry Hills, New South Wales, Australia
| | - Mahul Amin
- Department of Pathology and Laboratory medicine, University of Tennessee Health Sciences, Memphis, Tennessee, USA
| | - Athanase Billis
- Department of Anatomic Pathology, Universidade Estadual de Campinas, Campinas, Brazil
| | - Philippe Camparo
- Service d'anatomie et cytologie pathologiques, Hopital Foch, Paris, France
| | - Stewart Fleming
- Department of Cellular and Molecular Pathology, University of Dundee, Dundee, UK
| | - David Griffiths
- Department of Pathology, University Hospital of Wales, Cardiff, UK
| | - Antonio Lopez-Beltran
- Department of Pathology and Surgery, Cordoba University Medical School, /Cordoba, Spain
| | - Guido Martignoni
- Anatomia Patologica, Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Holger Moch
- Department of Pathology, Institute for Surgical Pathology, University Hospital, Zurich, Switzerland
| | - John N Nacey
- Department of Surgery and Anaesthesia, Wellington Sch Med, Wellington, New Zealand
| | - Ming Zhou
- Department of Pathology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Andrew John Evans
- Department of Pathology, University Health Network, Toronto, Ontario, Canada
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28
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Louis DN, Wesseling P, Brandner S, Brat DJ, Ellison DW, Giangaspero F, Hattab EM, Hawkins C, Judge MJ, Kleinschmidt-DeMasters B, Komori T, McLean C, Paulus W, Perry A, Reifenberger G, Weller M, Rous B. Data Sets for the Reporting of Tumors of the Central Nervous System: Recommendations From The International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2019; 144:196-206. [PMID: 31219344 DOI: 10.5858/arpa.2018-0565-oa] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Standards for pathology reporting of cancer are foundational to national and international benchmarking, epidemiology, and clinical trials, with international standards for pathology reporting of cancer being undertaken through the International Collaboration on Cancer Reporting (ICCR). OBJECTIVE.— To develop standardized templates for brain tumor diagnostic pathology reporting. DESIGN.— As a response to the 2016 updated 4th edition of the WHO (World Health Organization) Classification of Tumours of the Central Nervous System (2016 CNS WHO), an expert ICCR committee developed data sets to facilitate reporting of brain tumors that are classified histologically and molecularly by the 2016 CNS WHO; as such, this represents the first combined histologic and molecular ICCR data set, and required a novel approach with 3 highly related data sets that should be used in an integrated manner. RESULTS.— The current article and accompanying ICCR Web site describe reporting data sets for central nervous system tumors in the hope that they provide easy-to-use and highly reproducible means to issue diagnostic reports in consort with the 2016 CNS WHO. CONCLUSIONS.— The consistent use of these templates will undoubtedly prove useful for patient care, clinical trials, epidemiologic studies, and monitoring of neuro-oncologic care around the world.
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Affiliation(s)
- David N Louis
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Pieter Wesseling
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Sebastian Brandner
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Daniel J Brat
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - David W Ellison
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Felice Giangaspero
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Eyas M Hattab
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Cynthia Hawkins
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Meagan J Judge
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Bette Kleinschmidt-DeMasters
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Takashi Komori
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Catriona McLean
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Werner Paulus
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Arie Perry
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Guido Reifenberger
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Michael Weller
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
| | - Brian Rous
- From the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Louis); the Department of Pathology, Amsterdam Universities Medical Center/VUmc CCA Brain Tumor Center, Amsterdam, the Netherlands (Dr Wesseling); he Department of Pathology, Princess Máxima Center for Pediatric Oncology, and University Medical Center Utrecht, Utrecht, the Netherlands (Dr Wesseling); Division of Neuropathology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom (Dr Brandner); the Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom (Dr Brandner); the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Brat); the Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee (Dr Ellison); the Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy (Dr Giangaspero); RCCS Neuromed, Pozzilli, Isernia, Italy (Dr Giangaspero); the Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky (Dr Hattab); the Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Hawkins); Project Management Office, Royal College of Pathologists of Australasia, Sydney, Australia (Ms Judge);he Departments of Pathology, Neurology, and Neurosurgery, University of Colorado, Aurora (Dr Kleinschmidt-DeMasters); the Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan (Dr Komori); the Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan (Dr Komori); Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, Victoria, Australia (Dr McLean); Institute of Neuropathology, University Hospital Münster, Münster, Germany (Dr Paulus); Division of Neuropathology, Department of Pathology, University of California, San Francisco (Dr Perry); the Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany (Dr Reifenberger); German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany (Dr Reifenberger); the Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (Dr Weller); and the Department of Histopathology, Addenbrookes Hospital, Cambridge, United Kingdom (Dr Rous); ICCR Steering Group Representative (Dr Rous)
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Dataset for the reporting of prostate carcinoma in radical prostatectomy specimens: updated recommendations from the International Collaboration on Cancer Reporting. Virchows Arch 2019; 475:263-277. [DOI: 10.1007/s00428-019-02574-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 03/29/2019] [Accepted: 04/04/2019] [Indexed: 01/08/2023]
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Delahunt B, Srigley JR, Judge MJ, Amin MB, Billis A, Camparo P, Evans AJ, Fleming S, Griffiths DF, Lopez-Beltran A, Martignoni G, Moch H, Nacey JN, Zhou M. Data set for the reporting of carcinoma of renal tubular origin: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2019; 74:377-390. [PMID: 30325065 DOI: 10.1111/his.13754] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/13/2018] [Indexed: 12/29/2022]
Abstract
AIMS The International Collaboration on Cancer Reporting (ICCR) has provided detailed data sets based upon the published reporting protocols of the Royal College of Pathologists, the Royal College of Pathologists of Australasia and the College of American Pathologists. METHODS AND RESULTS The data set for carcinomas of renal tubular origin treated by nephrectomy was developed to provide a minimum structured reporting template suitable for international use, and incorporated recommendations from the 2012 Vancouver Consensus Conference of the International Society of Urological Pathology (ISUP) and the fourth edition of the World Health Organisation Bluebook on tumours of the urinary and male genital systems published in 2016. Reporting elements were divided into those, which are required and recommended components of the report. Required elements are: specimen laterality, operative procedure, attached structures, tumour focality, tumour dimension, tumour type, WHO/ISUP grade, sarcomatoid/rhabdoid morphology, tumour necrosis, extent of invasion, lymph node status, surgical margin status, AJCC TNM staging and co-existing pathology. Recommended reporting elements are: pre-operative treatment, details of tissue removed for experimental purposes prior to submission, site of tumour(s) block identification key, extent of sarcomatoid and/or rhabdoid component, extent of necrosis, presence of tumour in renal vein wall, lymphovascular invasion and lymph node status (size of largest focus and extranodal extension). CONCLUSIONS It is anticipated that the implementation of this data set in routine clinical practice will inform patient treatment as well as provide standardised information relating to outcome prediction. The harmonisation of data reporting should also facilitate international research collaborations.
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Affiliation(s)
- Brett Delahunt
- Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - John R Srigley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Meagan J Judge
- Royal College of Pathologists of Australasia, Sydney, Australia
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences, Memphis - Department of Urology, University of Tennessee Health Sciences, Memphis, TN, USA
| | - Athanase Billis
- Department of Anatomical Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil
| | - Philippe Camparo
- Department of Pathology, Centre de Pathologie Amiens, Amiens, France
| | - Andrew J Evans
- Department of Pathology and Laboratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Stewart Fleming
- Department of Cellular and Molecular Pathology, University of Dundee, Ninewells Hospital, Dundee
| | - David F Griffiths
- Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | | | - Guido Martignoni
- Department of Pathology and Diagnostics, University of Verona, Verona - Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Holger Moch
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - John N Nacey
- Department of Surgery and Anaesthesia, Wellington School of Medicine and Health Sciences, Wellington, New Zealand
| | - Ming Zhou
- Department of Pathology, NYU Langone Medical Center, New York, NY, USA
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Maharaj AD, Ioannou L, Croagh D, Zalcberg J, Neale RE, Goldstein D, Merrett N, Kench JG, White K, Pilgrim CHC, Chantrill L, Cosman P, Kneebone A, Lipton L, Nikfarjam M, Philip J, Sandroussi C, Tagkalidis P, Chye R, Haghighi KS, Samra J, Evans SM. Monitoring quality of care for patients with pancreatic cancer: a modified Delphi consensus. HPB (Oxford) 2019; 21:444-455. [PMID: 30316625 DOI: 10.1016/j.hpb.2018.08.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/02/2018] [Accepted: 08/31/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Best practise care optimises survival and quality of life in patients with pancreatic cancer (PC), but there is evidence of variability in management and suboptimal care for some patients. Monitoring practise is necessary to underpin improvement initiatives. We aimed to develop a core set of quality indicators that measure quality of care across the disease trajectory. METHODS A modified, three-round Delphi survey was performed among experts with wide experience in PC care across three states in Australia. A total of 107 potential quality indicators were identified from the literature and divided into five areas: diagnosis and staging, surgery, other treatment, patient management and outcomes. A further six indicators were added by the panel, increasing potential quality indicators to 113. Rated on a scale of 1-9, indicators with high median importance and feasibility (score 7-9) and low disagreement (<1) were considered in the candidate set. RESULTS From 113 potential quality indicators, 34 indicators met the inclusion criteria and 27 (7 diagnosis and staging, 5 surgical, 4 other treatment, 5 patient management, 6 outcome) were included in the final set. CONCLUSIONS The developed indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research in PC care.
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Affiliation(s)
- Ashika D Maharaj
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Liane Ioannou
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Daniel Croagh
- Monash University, Melbourne, Victoria, Australia; Monash Health, Clayton, Victoria, Australia; Epworth Healthcare, Richmond, Australia
| | - John Zalcberg
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Herston, Australia
| | - David Goldstein
- Prince of Wales Clinical School, UNSW Medicine, NSW, Australia
| | - Neil Merrett
- School of Medicine, Western Sydney University, NSW, Australia
| | - James G Kench
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Central Clinical School, University of Sydney, NSW, Australia
| | - Kate White
- Sydney Nursing School, University of Sydney, Australia
| | - Charles H C Pilgrim
- Alfred Health, Melbourne, Victoria, Australia; Cabrini, Malvern, Victoria, Australia; Peninsula Health, Frankston, Victoria, Australia; Peninsula Private Hospital, Frankston, Victoria, Australia
| | - Lorraine Chantrill
- Kinghorn Cancer Centre, St Vincent's Hospital, NSW, Australia; Garvan Institute of Medical Research and University of New South Wales, NSW, Australia
| | - Peter Cosman
- School of Medicine, Faculty of Science, Medicine & Health, University of Wollongong, NSW, Australia
| | | | - Lara Lipton
- Cabrini, Malvern, Victoria, Australia; Royal Melbourne Hospital, Parkville, Victoria, Australia; Western Health, Sunshine, Victoria, Australia
| | - Mehrdad Nikfarjam
- Melbourne University, Parkville, Victoria, Australia; Austin Health, Heidelberg, Australia
| | | | | | - Peter Tagkalidis
- Alfred Health, Melbourne, Victoria, Australia; Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Richard Chye
- St Vincent's Private Hospital, Darlinghurst, NSW, Australia; Faculty of Health, University of Technology, NSW, Australia
| | - Koroush S Haghighi
- Prince of Wales Clinical School, UNSW Medicine, NSW, Australia; Kinghorn Cancer Centre, St Vincent's Hospital, NSW, Australia
| | - Jaswinder Samra
- Department of Upper GI Surgery, Royal North Shore Hospital, NSW, Australia; Macquarie University Hospital, Macquarie University, Australia
| | - Sue M Evans
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
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Benton SJ, Lafreniere AJ, Grynspan D, Bainbridge SA. A synoptic framework and future directions for placental pathology reporting. Placenta 2019; 77:46-57. [DOI: 10.1016/j.placenta.2019.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/06/2019] [Accepted: 01/08/2019] [Indexed: 12/17/2022]
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Renshaw AA, Gould EW. Improving Discrete Data Capture in Synoptic Reports With Optional Free-Text Modifiers. JCO Clin Cancer Inform 2019; 2:1-6. [PMID: 30652544 DOI: 10.1200/cci.17.00127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Upfront, discrete data capture in synoptic reporting fails when pathologists choose a response not associated with discrete data. We sought to determine the factors associated with this event. METHODS The results of all "Other" entries in four common tumor sites in synoptic reports were reviewed. RESULTS "Other" entries occurred in 329 of 13,421 questions (2.5%). In 306 of these 329 questions (93.0%), the pathologist appeared to choose this response because they wished to add additional information to an already existing response that was associated with discrete data capture. As a result, the addition of a free-text modifiers to existing responses would allow pathologist to add this additional information while still selecting a response associated with discrete data capture, significantly improving the total discrete data capture (13,092 of 13,421 questions [97.5%] v 13,398 of 13,421 questions [99.8%]; P < .001). CONCLUSION The addition of free-text modifiers to structured responses in synoptic reports could significantly improve the discrete data capture rate.
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Affiliation(s)
- Andrew A Renshaw
- Andrew A. Renshaw and Edwin W. Gould, Miami Cancer Institute and Baptist Hospital, Miami, FL
| | - Edwin W Gould
- Andrew A. Renshaw and Edwin W. Gould, Miami Cancer Institute and Baptist Hospital, Miami, FL
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Renshaw AA, Mena-Allauca M, Gould EW, Sirintrapun SJ. Synoptic Reporting: Evidence-Based Review and Future Directions. JCO Clin Cancer Inform 2018; 2:1-9. [PMID: 30652566 PMCID: PMC6873952 DOI: 10.1200/cci.17.00088] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Andrew A. Renshaw
- Andrew A. Renshaw, Mercy Mena-Allauca, and Edwin W. Gould, Baptist Health South Florida, Miami, FL; and S. Joseph Sirintrapun, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mercy Mena-Allauca
- Andrew A. Renshaw, Mercy Mena-Allauca, and Edwin W. Gould, Baptist Health South Florida, Miami, FL; and S. Joseph Sirintrapun, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Edwin W. Gould
- Andrew A. Renshaw, Mercy Mena-Allauca, and Edwin W. Gould, Baptist Health South Florida, Miami, FL; and S. Joseph Sirintrapun, Memorial Sloan Kettering Cancer Center, New York, NY
| | - S. Joseph Sirintrapun
- Andrew A. Renshaw, Mercy Mena-Allauca, and Edwin W. Gould, Baptist Health South Florida, Miami, FL; and S. Joseph Sirintrapun, Memorial Sloan Kettering Cancer Center, New York, NY
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Patel A, Rockall A, Guthrie A, Gleeson F, Worthy S, Grubnic S, Burling D, Allen C, Padhani A, Carey B, Cavanagh P, Peake MD, Brown G. Can the completeness of radiological cancer staging reports be improved using proforma reporting? A prospective multicentre non-blinded interventional study across 21 centres in the UK. BMJ Open 2018; 8:e018499. [PMID: 30282676 PMCID: PMC6169672 DOI: 10.1136/bmjopen-2017-018499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Following a diagnosis of cancer, the detailed assessment of prognostic stage by radiology is a crucial determinant of initial therapeutic strategy offered to patients. Pretherapeutic stage by imaging is known to be inconsistently documented. We tested whether the completeness of cancer staging radiology reports could be improved through a nationally introduced pilot of proforma-based reporting for a selection of six common cancers. DESIGN Prospective interventional study comparing the completeness of radiology cancer staging reports before and after the introduction of proforma reporting. SETTING Twenty-one UK National Health Service hospitals. PARTICIPANTS 1283 cancer staging radiology reports were submitted. MAIN OUTCOME MEASURES Radiology staging reports across the six cancers types were evaluated before and after the implementation of proforma-based reporting. Report completeness was assessed using scoring forms listing the presence or absence of predetermined key staging data. Qualitative data regarding proforma implementation and usefulness were collected from questionnaires provided to radiologists and end-users. RESULTS Electronic proforma-based reporting was successfully implemented in 15 of the 21 centres during the evaluation period. A total of 787 preproforma and 496 postproforma staging reports were evaluated. In the preproforma group, only 48.7% (5586/11 470) of key staging items were present compared with 87.3% (6043/6920) in the postproforma group. Thus, the introduction of proforma reporting produced a 78% improvement in staging completeness . This increase was seen across all cancer types and centres. The majority of participants found proforma reporting improved cancer reporting quality for their clinical practice . CONCLUSION The implementation of proforma reporting results in a significant improvement in the completeness of cancer staging reports. Proforma-based assessment of cancer stage enables objective comparisons of patient outcomes across centres. It should therefore become an auditable quality standard for cancer care.
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Affiliation(s)
- Anisha Patel
- Department of Radiology, Royal Marsden Hospital, London, UK
| | - Andrea Rockall
- Department of Radiology, Royal Marsden Hospital, London, UK
| | - Ashley Guthrie
- Department of Radiology, St James’ University Hospital, Leeds, UK
| | | | - Sylvia Worthy
- Department of Radiology, Newcastle upon Tyne Hospital, Newcastle, UK
| | - Sisa Grubnic
- Department of Radiology, St George’s Hospital, London, UK
| | - David Burling
- Department of Radiology, St Mark’s Hospital, London, UK
| | - Clare Allen
- Department of Radiology, University College Hospital, London, UK
| | - Anwar Padhani
- Department of Radiology, Mount Vernon Cancer Centre, London, UK
| | - Brendan Carey
- Department of Radiology, Leeds Teaching Hospitals, Leeds, UK
| | - Peter Cavanagh
- Department of Radiology, Musgrove Park Hospital, Taunton, UK
| | - Michael D Peake
- Respiratory Medicine, University Hospitals of Leicester, Leicester, UK
| | - Gina Brown
- Department of Radiology, Royal Marsden Hospital, London, UK
- Department of Surgery & Cancer, Imperial College, London, UK
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Itchins M, J A, N P, C N, E G, A M, R M, L B, G S, AJ G, C D, M K, G H, A K, A M, J S, S C, S B, G M. Pattern of care and survival of pancreatic ductal adenocarcinoma in a multi-disciplinary high-volume centre. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/ghoa.2018.09.00323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Burt AD, Alves V, Bedossa P, Clouston A, Guido M, Hübscher S, Kakar S, Ng I, Park YN, Reeves H, Wyatt J, Yeh MM, Ellis DW. Data set for the reporting of intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma and hepatocellular carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2018; 73:369-385. [DOI: 10.1111/his.13520] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Alastair D Burt
- Faculty of Health and Medical Sciences; University of Adelaide; Adelaide Australia
| | - Venâncio Alves
- Department of Pathology; University of São Paulo School of Medicine; São Paulo Brazil
| | - Pierre Bedossa
- Pathology Department; AP-HP; Beaujon Hospital; Clichy France
- Centre de Recherche Bichat-Beaujon; University Paris-Diderot; Paris France
| | - Andrew Clouston
- Envoi Specialist Pathologists; Brisbane Queensland Australia
| | - Maria Guido
- Surgical Pathology and Cytopathology Unit; Department of Medicine-DIMED; University of Padova; Padova Italy
| | - Stefan Hübscher
- Department of Cellular Pathology; Institute of Immunology and Immunotherapy; University of Birmingham; Queen Elizabeth Hospital; Birmingham UK
| | | | - Irene Ng
- Department of Pathology; State Key Laboratory for Liver Research; The University of Hong Kong; Hong Kong Hong Kong
| | - Young N Park
- Department of Pathology Yonsei; Univesity College of Medicine Seodaemun-gu; Seoul Korea
| | - Helen Reeves
- Northern Institute for Cancer Research, Newcastle University; Newcastle upon Tyne UK
| | - Judith Wyatt
- Department of Histopathology; St James University Hospital; Leeds UK
| | - Matthew M Yeh
- Department of Pathology; University of Washington School of Medicine; Seattle WA USA
| | - David W Ellis
- Clinpath Laboratories; Kent Town South Australia Australia
- ICCR Steering Group Representative; Adelaide Australia
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Brown KM, Xue A, Julovi SM, Gill AJ, Pavlakis N, Samra JS, Smith RC, Hugh TJ. Using patient-derived xenograft models of colorectal liver metastases to predict chemosensitivity. J Surg Res 2018; 227:158-167. [PMID: 29804848 DOI: 10.1016/j.jss.2018.02.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/23/2018] [Accepted: 02/13/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Few in vivo models for colorectal cancer have been demonstrated to show external validity by accurately predicting clinical patient outcomes. Patient-derived xenograft (PDX) models of cancer have characteristics that might provide a form of translational research leading to personalized cancer care. The aim of this pilot study was to assess the feasibility of using PDXs as a platform for predicting patient colorectal liver metastases responses, in this case by correlating PDX and patient tumor responses to either folinic acid, fluorouracil plus oxaliplatin or folinic acid, fluorouracil plus irinotecan-based regimens. METHODS Sixteen patients underwent potentially curative resection of colorectal liver metastases, and tumors were grafted into NOD.CB17-Prkdcscid/Arc mice. Mice were divided into groups to determine relative tumor growth in response to treatment. Tumors were analyzed by immunohistochemistry for Ki67 and Excision repair cross-complementation group 1. RESULTS An engraftment rate of 81% was achieved. Overall, there was a 67% positive match rate between eligible patient and PDX chemosensitivity profiles. There was a significant difference in relative decrease in Ki67 expression between sensitive/stable versus resistant PDXs for both treatment regimens. There was no statistically significant correlation between baseline ERCC1 expression and response to Oxaliplatin + 5-Fluorouracil in the PDXs. CONCLUSIONS This pilot study supports the feasibility of using PDX models of advanced colorectal cancer in larger studies to potentially predict patient chemosensitivity profiles.
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Affiliation(s)
- Kai M Brown
- Cancer Surgery and Metabolism Research Group, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Northern Clinical School, University of Sydney, Upper GI Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St Leonards, New South Wales, Australia.
| | - Aiqun Xue
- Cancer Surgery and Metabolism Research Group, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Northern Clinical School, University of Sydney, Upper GI Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St Leonards, New South Wales, Australia
| | - Sohel M Julovi
- Cancer Surgery and Metabolism Research Group, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Nick Pavlakis
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Jaswinder S Samra
- Northern Clinical School, University of Sydney, Upper GI Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St Leonards, New South Wales, Australia
| | - Ross C Smith
- Cancer Surgery and Metabolism Research Group, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Thomas J Hugh
- Cancer Surgery and Metabolism Research Group, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Northern Clinical School, University of Sydney, Upper GI Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St Leonards, New South Wales, Australia
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Renshaw AA, Mena-Allauca M, Gould EW. Tabular Versus Synoptic Reporting of Prostate Core Needle Biopsies. JCO Clin Cancer Inform 2017; 1:1-7. [PMID: 30657378 DOI: 10.1200/cci.17.00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare synoptic versus tabular formats for reporting prostate core needle biopsy results. The format of a report can significantly affect the accuracy, speed, and preference with which a reader can retrieve information. METHODS We compared the performance of 20 nonpathologists in the identification of specific information in synoptic and tabular reports using a computerized quiz that measured both accuracy and speed. RESULTS Tabular formatting was significantly more accurate (97% v 93%; P = .001) and faster (mean normalized time, 0.74 + 0.40 v 0.99 + 0.52; P < .001) than synoptic formatting. The improvement in accuracy was a result of questions that involved combining results from two different biopsies (96% v 92%; P = .03). The improvement in speed was observed for both single-value questions (0.77 + 0.41 v 0.87 + 0.39; P = .03) and combination questions (0.73 + 0.40 v 1.05 + 0.56; P < .001). Data extraction from a tabular format into a structured data file using free text extraction on the basis of punctuation was 100% successful. CONCLUSION Tabular reporting of prostate needle biopsies allows significantly faster and more accurate identification of data by the user, especially when the data involve combining data from several biopsies. The tabular format does not impact the ability to create structured data files.
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Affiliation(s)
- Andrew A Renshaw
- All authors: Baptist Hospital and Miami Cancer Institute, Baptist Health of South Florida Healthcare System, Miami, FL
| | - Mercy Mena-Allauca
- All authors: Baptist Hospital and Miami Cancer Institute, Baptist Health of South Florida Healthcare System, Miami, FL
| | - Edwin W Gould
- All authors: Baptist Hospital and Miami Cancer Institute, Baptist Health of South Florida Healthcare System, Miami, FL
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Osipov A, Nissen N, Rutgers J, Dhall D, Naziri J, Chopra S, Li Q, Hendifar AE, Tuli R. Redefining the Positive Margin in Pancreatic Cancer: Impact on Patterns of Failure, Long-Term Survival and Adjuvant Therapy. Ann Surg Oncol 2017; 24:3674-3682. [PMID: 28871564 DOI: 10.1245/s10434-017-6076-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE There is debate regarding the definition and clinical significance of margin clearance in pancreatic ductal adenocarcinoma (PDA). A comprehensive archival analysis of surgical resection margins was performed to determine the effect on locoregional recurrence and survival, and the impact of adjuvant therapy in PDA. METHODS We identified 105 patients with resected PDA. Pancreatic, anterior, bile duct, and posterior surgical resection margins (PM; posterior surface, uncinate and vascular groove) were identified. Three pathologists reviewed all archival surgical specimens and recategorized each margin as tumor at ink/transected, <0.5, 0.5-1, >1-2, or >2 mm from the inked surface. The impact of these and other clinical variables was assessed on local control, disease-free survival (DFS), and overall survival (OS). RESULTS Among all margins, PM clearance up to 2 mm was prognostic of DFS (p = 0.01) and OS (p = 0.01). Dichotomizing the PM at 2 mm revealed it to be an independent predictor of local recurrence-free survival [hazard ratio HR] 0.20, 95% confidence interval [CI] 0.048-0.881, p = 0.033), DFS (HR 0.46, 95% CI 0.22-0.96, p = 0.03), and OS (HR 0.31, 95% CI 0.14-0.74, p = 0.008). A margin status of >2 mm was also prognostic of OS in patients who received adjuvant chemotherapy (HR 0.31, 95% CI 0.11-0.89, p = 0.03), however this difference was mitigated in patients receiving adjuvant chemoradiotherapy (HR 0.40, 95% CI 0.10-1.58, p = 0.19). CONCLUSION These data highlight the clinical significance of the PM and the lack of significance of other resection margins. Clearance in excess of 2 mm should be considered to improve long-term clinical outcomes. The use of adjuvant radiotherapy should be strongly considered in patients with PMs <2 mm.
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Affiliation(s)
- Arsen Osipov
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nicholas Nissen
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Joanne Rutgers
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Deepti Dhall
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jason Naziri
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Shefali Chopra
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Quanlin Li
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Richard Tuli
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Itchins M, Arena J, Nahm CB, Rabindran J, Kim S, Gibbs E, Bergamin S, Chua TC, Gill AJ, Maher R, Diakos C, Wong M, Mittal A, Hruby G, Kneebone A, Pavlakis N, Samra J, Clarke S. Retrospective cohort analysis of neoadjuvant treatment and survival in resectable and borderline resectable pancreatic ductal adenocarcinoma in a high volume referral centre. Eur J Surg Oncol 2017; 43:1711-1717. [PMID: 28688722 DOI: 10.1016/j.ejso.2017.06.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/28/2017] [Accepted: 06/09/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease. Neoadjuvant therapy (NA) with chemotherapy (NAC) and radiotherapy (RT) prior to surgery provides promise. In the absence of prospective data, well annotated clinical data from high-volume units may provide pilot data for randomised trials. METHODS Medical records from a tertiary hospital in Sydney, Australia, were analysed to identify all patients with resectable or borderline resectable PDAC. Data regarding treatment, toxicity and survival were collected. RESULTS Between January 1 2010 and April 1 2016, 220 sequential patients were treated: 87 with NA and 133 with upfront operation (UO). Forty-three NA patients (52%) and 5 UO patients (4%) were borderline resectable at diagnosis. Twenty-four borderline patients received NA RT, 22 sequential to NAC. The median overall survival (OS) in the NA group was 25.9 months (mo); 95% CI (21.1-43.0 mo) compared to 26.9 mo (19.7, 32.7) in the UO; HR 0.89; log-ranked p-value = 0.58. Sixty-nine NA patients (79%) were resected, mOS was 29.2 mo (22.27, not reached (NR)). Twenty-two NA (31%) versus 22 UO (17%) were node negative at operation (N0). In those managed with NAC/RT the mOS was 29.0 mo (17.3, NR). There were no post-operative deaths with NA within 90-days and three in the UO arm. DISCUSSION This is a hypothesis generating retrospective review of a selected real-world population in a high-throughput unit. Treatment with NA was well tolerated. The long observed survival in this group may be explained by lymph node sterilisation by NA, and the achievement of R0 resection in a greater proportion of patients.
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Affiliation(s)
- M Itchins
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia.
| | - J Arena
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - C B Nahm
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - J Rabindran
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - S Kim
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia
| | - E Gibbs
- National Health and Medical Research Council Clinical Trial Centre (NHMRC CTC), The University of Sydney, Australia
| | - S Bergamin
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - T C Chua
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia
| | - A J Gill
- Sydney Medical School (Northern), The University of Sydney, Australia; Cancer Diagnosis and Pathology, Kolling Institute, Royal North Shore Hospital, Sydney, Australia
| | - R Maher
- Department of Radiology, Royal North Shore Hospital, Australia
| | - C Diakos
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia; Northern Cancer Institute, Sydney, NSW, Australia
| | - M Wong
- Department of Medical Oncology, Gosford Hospital, New South Wales, Australia
| | - A Mittal
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - G Hruby
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - A Kneebone
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - N Pavlakis
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia; Northern Cancer Institute, Sydney, NSW, Australia
| | - J Samra
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - S Clarke
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia; Northern Cancer Institute, Sydney, NSW, Australia
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Tack V, Dufraing K, Deans ZC, van Krieken HJ, Dequeker EMC. The ins and outs of molecular pathology reporting. Virchows Arch 2017; 471:199-207. [PMID: 28343306 DOI: 10.1007/s00428-017-2108-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/07/2017] [Accepted: 03/12/2017] [Indexed: 01/15/2023]
Abstract
The raid evolution in molecular pathology resulting in an increasing complexity requires careful reporting. The need for standardisation is clearer than ever. While synoptic reporting was first used for reporting hereditary genetic diseases, it is becoming more frequent in pathology, especially molecular pathology reports too. The narrative approach is no longer feasible with the growing amount of essential data present on the report, although narrative components are still necessary for interpretation in molecular pathology. On the way towards standardisation of reports, guidelines can be a helpful tool. There are several guidelines that focus on reporting in the field of hereditary diseases, but it is not always feasible to extrapolate these to the reporting of somatic variants in molecular pathology. The rise of multi-gene testing causes challenges for the laboratories. In order to provide a continuous optimisation of the laboratory testing process, including reporting, external quality assessment is essential and has already proven to improve the quality of reports. In general, a clear and concise report for molecular pathology can be created by including elements deemed important by different guidelines, adapting the report to the process flows of the laboratory and integrating the report with the laboratory information management system and the patient record.
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Affiliation(s)
- Véronique Tack
- Biomedical Quality Assurance Research Unit, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok D, 3000, Leuven, Belgium
| | - Kelly Dufraing
- Biomedical Quality Assurance Research Unit, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok D, 3000, Leuven, Belgium
| | - Zandra C Deans
- Department of Laboratory Medicine, UK NEQAS for Molecular Genetics, UK NEQAS Edinburgh, The Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Han J van Krieken
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elisabeth M C Dequeker
- Biomedical Quality Assurance Research Unit, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok D, 3000, Leuven, Belgium.
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Townend P, de Reuver PR, Chua TC, Mittal A, Clark SJ, Pavlakis N, Gill AJ, Samra JS. Histopathological tumour viability after neoadjuvant chemotherapy influences survival in resected pancreatic cancer: analysis of early outcome data. ANZ J Surg 2017; 88:E167-E172. [PMID: 28318082 DOI: 10.1111/ans.13897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/03/2016] [Accepted: 12/06/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Neoadjuvant therapy is increasingly recognized as an effective strategy prior to pancreatoduodenectomy. We investigate the role of neoadjuvant chemotherapy (NAC) followed by surgery and the predictive role of viable residual tumour cells histopathologically on outcomes. METHODS The study population comprised of 195 consecutive patients with pancreatic adenocarcinoma who were treated with either NAC or a surgery-first (SF) strategy. Histopathological viable tumour cells were examined in the NAC patients and clinicopathological factors were correlated with overall survival. RESULTS Forty-two patients (22%) were treated with NAC and 153 patients (78%) underwent SF. NAC was associated with higher estimated blood loss during surgery (928 mL versus 615 mL; P = 0.004), fewer (<15) excised lymph nodes (37% versus 17%; P = 0.015) and lower rates of lymphovascular invasion (65% versus 45%; P = 0.044) when compared with SF. Two-year survival of patients undergoing NAC was 63% and 51% in patients undergoing SF (P = 0.048). The 2-year survival of patients who had >65% residual tumour cells was 45% and 90% in patients who had <65% residual tumour cells (P = 0.022). Favourable responders (<65% viable tumour cells) were observed to have shorter operation time (<420 min) (55% versus 13%; P = 0.038), trend towards negative lymph node status (38% versus 10%; P = 0.067) and greater lymph node harvest in node positive patients (≥4 positive lymph nodes) (77% versus 37%; P = 0.045). CONCLUSION The improved survival of patients undergoing NAC indicates effective management of micrometastatic disease and is an effective option requiring further investigation. Histopathological viable tumour cells after NAC was a surrogate marker for survival.
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Affiliation(s)
- Phil Townend
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia
| | - Phil R de Reuver
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia
| | - Terence C Chua
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia
| | - Anubhav Mittal
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephen J Clark
- Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Nick Pavlakis
- Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Deparment of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jaswinder S Samra
- Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Macquarie University Hospital, Macquarie University, Sydney, New South Wales, Australia
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Renshaw MA, Renshaw SA, Mena-Allauca M, Carrion PP, Mei X, Narciandi A, Gould EW, Renshaw AA. Performance of a Web-based Method for Generating Synoptic Reports. J Pathol Inform 2017; 8:13. [PMID: 28382227 PMCID: PMC5364739 DOI: 10.4103/jpi.jpi_91_16] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/22/2017] [Indexed: 12/14/2022] Open
Abstract
CONTEXT The College of American Pathologists (CAP) requires synoptic reporting of all tumor excisions. OBJECTIVE To compare the performance of different methods of generating synoptic reports. METHODS Completeness, amendment rates, rate of timely ordering of ancillary studies (KRAS in T4/N1 colon carcinoma), and structured data file extraction were compared for four different synoptic report generating methods. RESULTS Use of the printed tumor protocols directly from the CAP website had the lowest completeness (84%) and highest amendment (1.8%) rates. Reformatting these protocols was associated with higher completeness (94%, P < 0.001) and reduced amendment (1%, P = 0.20) rates. Extraction into a structured data file was successful 93% of the time. Word-based macros improved completeness (98% vs. 94%, P < 0.001) but not amendment rates (1.5%). KRAS was ordered before sign out 89% of the time. In contrast, a web-based product with a reminder flag when items were missing, an embedded flag for data extraction, and a reminder to order KRAS when appropriate resulted in improved completeness (100%, P = 0.005), amendment rates (0.3%, P = 0.03), KRAS ordering before sign out (100%, P = 0.23), and structured data extraction (100%, P < 0.001) without reducing the speed (P = 0.34) or accuracy (P = 1.00) of data extraction by the reader. CONCLUSION Completeness, amendment rates, ancillary test ordering rates, and data extraction rates vary significantly with the method used to construct the synoptic report. A web-based method compares favorably with all other methods examined and does not reduce reader usability.
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Affiliation(s)
| | | | - Mercy Mena-Allauca
- Department of Cancer Services, Baptist Hospital and Baptist Health of South Florida Healthcare System, Miami, FL, USA
| | - Patricia P. Carrion
- Department of Information Technology, Baptist Hospital and Baptist Health of South Florida Healthcare System, Miami, FL, USA
| | - Xiaorong Mei
- Department of Information Technology, Baptist Hospital and Baptist Health of South Florida Healthcare System, Miami, FL, USA
| | - Arniris Narciandi
- Department of Information Technology, Baptist Hospital and Baptist Health of South Florida Healthcare System, Miami, FL, USA
| | - Edwin W. Gould
- Department of Pathology, Baptist Hospital and Baptist Health of South Florida Healthcare System, Miami, FL, USA
| | - Andrew A. Renshaw
- Department of Pathology, Baptist Hospital and Baptist Health of South Florida Healthcare System, Miami, FL, USA
- Department of Pathology, Baptist Hospital, Miami, FL, USA
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45
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Foran DJ, Chen W, Chu H, Sadimin E, Loh D, Riedlinger G, Goodell LA, Ganesan S, Hirshfield K, Rodriguez L, DiPaola RS. Roadmap to a Comprehensive Clinical Data Warehouse for Precision Medicine Applications in Oncology. Cancer Inform 2017; 16:1176935117694349. [PMID: 28469389 PMCID: PMC5392017 DOI: 10.1177/1176935117694349] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 01/26/2017] [Indexed: 11/16/2022] Open
Abstract
Leading institutions throughout the country have established Precision Medicine programs to support personalized treatment of patients. A cornerstone for these programs is the establishment of enterprise-wide Clinical Data Warehouses. Working shoulder-to-shoulder, a team of physicians, systems biologists, engineers, and scientists at Rutgers Cancer Institute of New Jersey have designed, developed, and implemented the Warehouse with information originating from data sources, including Electronic Medical Records, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology and Pathology archives, and Next Generation Sequencing services. Innovative solutions were implemented to detect and extract unstructured clinical information that was embedded in paper/text documents, including synoptic pathology reports. Supporting important precision medicine use cases, the growing Warehouse enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information of patient tumors individually or as part of large cohorts to identify changes and patterns that may influence treatment decisions and potential outcomes.
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Affiliation(s)
- David J Foran
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Wenjin Chen
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Huiqi Chu
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Evita Sadimin
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Doreen Loh
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Gregory Riedlinger
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Lauri A Goodell
- Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Shridar Ganesan
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Kim Hirshfield
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Lorna Rodriguez
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Bell R, Ao BT, Ironside N, Bartlett A, Windsor JA, Pandanaboyana S. Meta-analysis and cost effective analysis of portal-superior mesenteric vein resection during pancreatoduodenectomy: Impact on margin status and survival. Surg Oncol 2017; 26:53-62. [PMID: 28317585 DOI: 10.1016/j.suronc.2016.12.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/21/2016] [Accepted: 12/29/2016] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The benefit of portal-superior mesenteric vein resection (PSMVR) with pancreatoduodenectomy (PD) remains controversial. This study assesses the impact of PSMVR on resection margin status and survival. METHOD An electronic search was performed to identify relevant articles. Pooled odds ratios were calculated for outcomes using the fixed or random-effects models for meta-analysis. A decision analytical model was developed for estimating cost effectiveness. RESULTS Sixteen studies with 4145 patients who underwent pancreatoduodenectomy were included: 1207 patients had PSMVR and 2938 patients had no PSMVR. The R1 resection rate and post-operative mortality was significantly higher in PSMVR group (OR1.59[1.35, 1.86] p=<0.0001, and OR1.72 [1.02,2.92] p = 0.04 respectively). The overall survival at 5-years was worse in the PSMVR group (HR0.20 [0.07,0.55] P = 0.020). Tumour size (p = 0.030) and perineural invasion (P = 0.009) were higher in the PSMVR group. Not performing PSMVR yielded cost savings of $1617 per additional month alive without reduction in overall outcome. CONCLUSION On the basis of retrospective data this study shows that PD with PSMVR is associated with a higher R1 rate, lower 5-year survival and is not cost-effective. It appears that PD with PSMVR can only be justified if R0 resection can be achieved. The continuing challenge is accurate selection of these patients.
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Affiliation(s)
- Richard Bell
- Department of HPB and Transplant Surgery, St James Hospital, Leeds, UK
| | - Braden Te Ao
- Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand
| | - Natasha Ironside
- HPB/Upper GI Unit, Department of Hepatobiliary and Pancreatic Surgery, Auckland City Hospital, New Zealand
| | - Adam Bartlett
- HPB/Upper GI Unit, Department of Hepatobiliary and Pancreatic Surgery, Auckland City Hospital, New Zealand; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - John A Windsor
- HPB/Upper GI Unit, Department of Hepatobiliary and Pancreatic Surgery, Auckland City Hospital, New Zealand; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sanjay Pandanaboyana
- HPB/Upper GI Unit, Department of Hepatobiliary and Pancreatic Surgery, Auckland City Hospital, New Zealand; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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47
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The effects of implementing synoptic pathology reporting in cancer diagnosis: a systematic review. Virchows Arch 2016; 468:639-49. [PMID: 27097810 PMCID: PMC4887530 DOI: 10.1007/s00428-016-1935-8] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/22/2016] [Accepted: 03/24/2016] [Indexed: 02/07/2023]
Abstract
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.
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King S, Dimech M, Johnstone S. Structured pathology reporting improves the macroscopic assessment of rectal tumour resection specimens. Pathology 2016; 48:349-52. [PMID: 27114373 DOI: 10.1016/j.pathol.2016.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 03/03/2016] [Accepted: 03/09/2016] [Indexed: 01/01/2023]
Abstract
We examined whether introduction of a structured macroscopic reporting template for rectal tumour resection specimens improved the completeness and efficiency in collecting key macroscopic data elements. Fifty free text (narrative) macroscopic reports retrieved from 2012 to 2014 were compared with 50 structured macroscopic reports from 2013 to 2015, all of which were generated at John Hunter Hospital, Newcastle, NSW. The six standard macroscopic data elements examined in this study were reported in all 50 anatomical pathology reports using a structured macroscopic reporting dictation template. Free text reports demonstrated significantly impaired data collection when recording intactness of mesorectum (p<0.001), relationship to anterior peritoneal reflection (p=0.028) and distance of tumour to the non-peritonealised circumferential margin (p<0.001). The number of words used was also significantly (p<0.001) reduced using pre-formatted structured reports compared to free text reports. The introduction of a structured reporting dictation template improves data collection and may reduce the subsequent administrative burden when macroscopically evaluating rectal resections.
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Affiliation(s)
- Simon King
- Department of Anatomical Pathology, Pathology North, John Hunter Hospital, Newcastle, NSW, Australia.
| | - Margaret Dimech
- Senior Project Manager, Royal College of Pathologists of Australasia, Surry Hills, Sydney, NSW, Australia
| | - Susan Johnstone
- Department of Anatomical Pathology, Pathology North, John Hunter Hospital, Newcastle, NSW, Australia
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Churg A, Attanoos R, Borczuk AC, Chirieac LR, Galateau-Sallé F, Gibbs A, Henderson D, Roggli V, Rusch V, Judge MJ, Srigley JR. Dataset for Reporting of Malignant Mesothelioma of the Pleura or Peritoneum: Recommendations From the International Collaboration on Cancer Reporting (ICCR). Arch Pathol Lab Med 2016; 140:1104-10. [PMID: 27031777 DOI: 10.5858/arpa.2016-0073-oa] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -The International Collaboration on Cancer Reporting is a not-for-profit organization formed by the Royal Colleges of Pathologists of Australasia and the United Kingdom; the College of American Pathologists; the Canadian Association of Pathologists-Association Canadienne des Pathologists, in association with the Canadian Partnership Against Cancer; and the European Society of Pathology. Its goal is to produce common, internationally agreed upon, evidence-based datasets for use throughout the world. OBJECTIVE -To describe a dataset developed by the Expert Panel of the International Collaboration on Cancer Reporting for reporting malignant mesothelioma of both the pleura and peritoneum. The dataset is composed of "required" (mandatory) and "recommended" (nonmandatory) elements. DESIGN -Based on a review of the most recent evidence and supported by explanatory commentary. RESULTS -Eight required elements and 7 recommended elements were agreed upon by the Expert Panel to represent the essential information for reporting malignant mesothelioma of the pleura and peritoneum. CONCLUSIONS -In time, the widespread use of an internationally agreed upon, structured, pathology dataset for mesothelioma will lead not only to improved patient management but also provide valuable data for research and international benchmarks.
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Affiliation(s)
- Andrew Churg
- From the Department of Pathology and Laboratory Medicine, University of British Columbia, and Vancouver General Hospital, Vancouver, British Columbia, Canada (Dr Churg); the Department of Cellular Pathology, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, United Kingdom (Drs Attanoos and Gibbs); the Department of Pathology, Weill Cornell University Medical Center, New York, New York (Dr Borczuk); the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Chirieac); the Department of Pathology, University Hospital Caen, and Department of Biopathology, Léon-Bérard Cancer Centre, Lyon, France (Dr Galateau-Sallé); the Department of Surgical Pathology, SA Pathology, Flinders Medical Centre, Adelaide, South Australia, Australia (Dr Henderson); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Roggli); the Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York (Dr Rusch); the Royal College of Pathologists of Australasia, Sydney, New South Wales, Australia (Ms Judge); and the Program of Laboratory Medicine and Genetics, Trillium Health Partners, and the Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada (Dr Srigley)
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Sever C, Abbott CL, de Baca ME, Khoury JD, Perkins SL, Reichard KK, Taylor A, Terebelo HR, Colasacco C, Rumble RB, Thomas NE. Bone Marrow Synoptic Reporting for Hematologic Neoplasms: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center. Arch Pathol Lab Med 2016; 140:932-49. [PMID: 26905483 DOI: 10.5858/arpa.2015-0450-sa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -There is ample evidence from the solid tumor literature that synoptic reporting improves accuracy and completeness of relevant data. No evidence-based guidelines currently exist for synoptic reporting for bone marrow samples. OBJECTIVE -To develop evidence-based recommendations to standardize the basic components of a synoptic report template for bone marrow samples. DESIGN -The College of American Pathologists Pathology and Laboratory Quality Center convened a panel of experts in hematopathology to develop recommendations. A systematic evidence review was conducted to address 5 key questions. Recommendations were derived from strength of evidence, open comment feedback, and expert panel consensus. RESULTS -Nine guideline statements were established to provide pathology laboratories with a framework by which to develop synoptic reporting templates for bone marrow samples. The guideline calls for specific data groups in the synoptic section of the pathology report; provides a list of evidence-based parameters for key, pertinent elements; and addresses ancillary testing. CONCLUSION -A framework for bone marrow synoptic reporting will improve completeness of the final report in a manner that is clear, succinct, and consistent among institutions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Nicole E Thomas
- From the Department of Hematopathology, Pathology Associates of Albuquerque, Albuquerque, New Mexico (Dr Sever); the Department of Pathology, Berkshire Medical Center, Pittsfield, Massachusetts (Dr Abbott); Medical Laboratory Associates, Seattle, Washington (Dr de Baca); the Department of Pathology, University of Texas MD Anderson Cancer Center, Houston (Dr Khoury); the Department of Pathology, University of Utah, Salt Lake City (Dr Perkins); the Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (Dr Reichard); Utah Pathology Services, Inc, Salt Lake City (Dr Taylor); the Department of Hematology/Medical Oncology, Newland Medical Associates, Novi, Michigan (Dr Terebelo); the Departments of Governance (Ms Colasacco) and Surveys (Ms Thomas), College of American Pathologists, Northfield, Illinois; and the Quality and Guidelines Department, American Society of Clinical Oncology, Alexandria, Virginia (Mr Rumble)
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