title: Contribution of referent pathologists to the quality of trophoblastic diseases diagnosis.
abstract: OBJECTIVE
  To evaluate the contribution of referent pathologists (RPs) to the quality of diagnosis of trophoblastic diseases and to study the level of diagnostic agreement between the initial pathologists and the RPs.
  
  
  METHODS
  This observational retrospective study was carried between 1 November 1999 and 11 January 2011 using the database of the French Trophoblastic Disease Reference Centre in Lyon. All files for hydatiform moles (HMs), trophoblastic tumours and non-molar pregnancies for which there was an initial suspicion of trophoblastic disease were included, whenever there was rereading of the slides by an RP. A total of 1851 HMs and 150 gestational trophoblastic tumours were analysed.
  
  
  RESULTS
  When the initial pathologist diagnosed a complete mole, the RP confirmed the diagnosis in 96% of cases. When the initial pathologist diagnosed a partial mole, the RP confirmed the diagnosis in only 64% of cases. For trophoblastic tumours, when the initial pathologist diagnosed a choriocarcinoma, the RP confirmed the diagnosis in 86% of cases. When the initial anatomopathology suggested an invasive mole, the diagnosis was confirmed in 96% of cases. Finally, when the initial diagnosis was a placental site trophoblastic tumour or an epithelioid trophoblastic tumour, the RP confirmed the diagnosis in 60 and 100% of cases, respectively.
  
  
  CONCLUSIONS
  A systematic policy of rereading of slides for all suspicious moles improves the quality of management of trophoblastic diseases at a national level.
authors.affiliation: Department of Obstetrics and Gynecology, Lyon 1 University, Lyon Hospital, Lyon Sud University Hospital, Lyon, France. francois.golfier@chu-lyon.fr
authors.forename: Francois
authors.initials: F
authors.lastname: Golfier
authors.forename: Jessica
authors.initials: J
authors.lastname: Clerc
authors.forename: Touria
authors.initials: T
authors.lastname: Hajri
authors.forename: Jerome
authors.initials: J
authors.lastname: Massardier
authors.forename: Lucien
authors.initials: L
authors.lastname: Frappart
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
authors.forename: Michele
authors.initials: M
authors.lastname: Rabreau
authors.forename: Sophie
authors.initials: S
authors.lastname: Patrier
authors.forename: Louise
authors.initials: L
authors.lastname: Devisme
authors.forename: Dominique
authors.initials: D
authors.lastname: Carles
authors.forename: Fanny
authors.initials: F
authors.lastname: Pelluard
authors.forename: Bernard
authors.initials: B
authors.lastname: Gasser
authors.forename: Colette
authors.initials: C
authors.lastname: Tarranger-Charpin
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schott
authors.forename: Daniel
authors.initials: D
authors.lastname: Raudrant
mesh_terms: D000293:Adolescent; D000328:Adult; D002822:Choriocarcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis*; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis*; D002820:Hydatidiform Mole, Invasive / Q000175:diagnosis; D008875:Middle Aged; D015588:Observer Variation; D010336:Pathology / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014328:Trophoblastic Neoplasms / Q000175:diagnosis*