title: Postsurgical pathology reporting of thyroid cancer in New South Wales, Australia.
abstract: BACKGROUND
  Clear, accurate, and complete reporting of postsurgical pathology is crucial for the correct evaluation and management of thyroid cancer patients. This study aimed to describe the completeness, as defined by international guidelines, of pathology reporting in a cohort of newly diagnosed thyroid cancer patients in New South Wales (NSW) and to identify factors associated with the completeness of reports.
  
  
  METHODS
  Postsurgical pathology reports, held by the NSW Central Cancer Registry, for 448 thyroid cancer patients were reviewed. Presence or absence of recommended key features (tumor histology type, maximum dimension, focality, completeness of excision, extrathyroidal extension, lymphovascular invasion, and lymph node involvement) was recorded. Associations between the number of key items reported and several patient characteristics were investigated.
  
  
  RESULTS
  For 285 (63.6%) patients one or more key pathological features were missing, with 177 (39.5%) missing one only, 88 (19.6%) missing two, and 20 (4.5%) missing three or more. Extrathyroidal extension was the most poorly reported key feature, being present in only 228 (50.9%) reports [95% confidence interval 46.2, 55.6]. Pathology reports were less complete for patients with small tumor size (p<0.001) or localized spread (p<0.001). Synoptic reports were significantly more complete than narrative-style reports (98.3% vs. 27.1%, p<0.001).
  
  
  CONCLUSIONS
  Postsurgical pathology reporting of differentiated thyroid cancer in NSW was found to be far from complete, with 64% of reports missing information on at least one feature that is considered internationally to be a critical factor in the prognosis and treatment of thyroid cancer patients. Synoptic reporting reduces the number of key features missing from pathology reports.
authors.affiliation: Cancer Epidemiology Research Unit, Cancer Council New South Wales, Kings Cross, NSW 1340, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Kahn
authors.forename: Leonardo
authors.initials: L
authors.lastname: Simonella
authors.forename: Mark
authors.initials: M
authors.lastname: Sywak
authors.forename: Steven
authors.initials: S
authors.lastname: Boyages
authors.forename: Owen
authors.initials: O
authors.lastname: Ung
authors.forename: Dianne
authors.initials: D
authors.lastname: O'Connell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D018276:Carcinoma, Medullary / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011184:Postoperative Period; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy; D055815:Young Adult