title: Centralised multidisciplinary re-evaluation of diagnostic procedures in patients with newly diagnosed Hodgkin lymphoma.
abstract: BACKGROUND
  Hodgkin Lymphoma (HL) is highly curable when treated accurately. The challenge is to cure patients with the minimal risk of long-term complications. For that, optimal initial diagnostics are required to determine the optimal treatment plan. We offer non-academic hospitals in our Regional Comprehensive Cancer Centre network a centralised review of all diagnostic procedures from patients with newly diagnosed HL. We report our experience on concordances and discrepancies between local findings and central review results.
  
  
  METHODS
  A haematologist and radiation oncologist at the Hodgkin Radboud University Nijmegen Medical Centre outpatient clinic examined all patients with newly diagnosed HL between February 2006 and May 2010. In a multidisciplinary lymphoma conference, diagnostic information is reviewed and treatment advice formulated. Discordant findings in pathology, staging and therapy were recorded as 'minor', no therapeutic consequences or 'major', adapted therapy advice.
  
  
  RESULTS
  Altogether, 125 patients were included. Pathology review showed 86% concordance, with 4% major discordance, mainly nodular lymphocyte predominant sub-type. Revision of initial staging was concordant in 77%; however 15% major discordance of which most were upstaged. This resulted in 19% treatment adaption.
  
  
  CONCLUSIONS
  Our findings highlight the discrepancies in interpretation of diagnostic tests. We advocate centralised review process for all newly diagnosed patients with HL.
authors: Departments of Hematology, RUN St Radboud, Nijmegen. Electronic address: w.stevens@hemat.umcn.nl.
authors: W B C
authors: WBC
authors: Stevens
authors: Departments of Pathology, RUN St Radboud, Nijmegen.
authors: J H
authors: JH
authors: van Krieken
authors: Departments of Radiology, RUN St Radboud, Nijmegen.
authors: R D M
authors: RDM
authors: Mus
authors: Departments of Nuclear Medicine, RUN St Radboud, Nijmegen.
authors: A I J
authors: AIJ
authors: Arens
authors: Department of Internal Medicine, Rijnstate Hospital, Arnhem.
authors: V
authors: V
authors: Mattijssen
authors: Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen.
authors: M
authors: M
authors: Oosterveld
authors: Department of Internal Medicine, Hospital de Gelderse Vallei, Ede.
authors: E J F M
authors: EJFM
authors: de Kruijf
authors: Department of Internal Medicine, Slingeland Hospital, Doetinchem.
authors: F
authors: F
authors: de Vries
authors: Department of Internal Medicine, VieCurie Medical Centre Noord-Limburg, Venlo.
authors: A
authors: A
authors: Koster
authors: Departments of Radiotherapy, RUN St Radboud, Nijmegen, The Netherlands.
authors: R
authors: R
authors: van der Maazen
authors: Departments of Hematology, RUN St Radboud, Nijmegen, The Netherlands.
authors: J
authors: J
authors: Raemaekers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011878:Radiotherapy; D055815:Young Adult