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Relevance of routine pathology review in cervical carcinoma

Abstract

To determine the impact of pathology review on the management of patients with cervical carcinoma, 264 reports of pathology review from 230 patients referred to Erasmus MC (2010–2012) were studied retrospectively. Discrepancies between pathologic diagnoses were classified as ‘major’ if they led to changes in treatment, and as ‘minor’ where there was no change. Patient and tumor characteristics were analyzed to identify the factors influencing these discrepancies. Fifty-eight (25.2%) discrepancies were identified; 28 (12.2%) were major, these resulted frequently from missing essential information, or discordant assessment of tumor invasion. Pathology review prevented under-treatment of 3.5%, over-treatment of 1.3%, treatment for incorrect malignancy of 1.3%, and enabled definitive treatment of 6.1% of patients. This highlights the importance of pathology review for appropriate management. Major discrepancies were rare (1%) for patients with macroscopic tumor and histologic diagnosis of squamous cell carcinoma (n = 100). For these patients, yield of pathology review may be limited.

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Conflict of interest

The authors declare that they have no conflict of interests.

Funding

No external funding was received.

Author information

Concept and design: H.J. van Beekhuizen, M.D. Freulings, P.C. Ewing-Graham, H.C. van Doorn. Data acquisition: H.J. van Beekhuizen, M.D. Freulings, P.C. Ewing-Graham, H.C. van Doorn. Data analysis/interpretation: H.J. van Beekhuizen, M.D. Freulings, P.C. Ewing-Graham, H.C. van Doorn. Drafting manuscript: H.J. van Beekhuizen, M.D. Freulings, S. Dasgupta, F.J. van Kemenade, P.C. Ewing-Graham, H.C. van Doorn. Critical revision of manuscript: H.J. van Beekhuizen, M.D. Freulings, S. Dasgupta, F.J. van Kemenade, P.C. Ewing-Graham, H.C. van Doorn. Statistical analysis: H.J. van Beekhuizen, M.D. Freulings, H.C. van Doorn. Supervision: H.J. van Beekhuizen, H.C. van Doorn. Final approval: All authors.

Correspondence to Helena C. van Doorn.

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The Dutch national guidelines state that no ethical approval is required for the use of anonymous leftover tissue (www.federa.org), and this is also part of a standard treatment agreement with patients at Erasmus MC.

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van Beekhuizen, H.J., Freulings, M.D., Dasgupta, S. et al. Relevance of routine pathology review in cervical carcinoma. Virchows Arch (2020) doi:10.1007/s00428-019-02743-1

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Keywords

  • Pathology review
  • Cervical carcinoma
  • Over-treatment
  • Under-treatment
  • Discrepancies