title: Interobserver variability of histopathological prognostic parameters in cutaneous malignant melanoma: impact on patient management.
abstract: Clinical management of primary cutaneous melanomas is based on histopathological staging of the tumour. The aim of this study was to investigate, in a non-selected population in clinical practice, the agreement rate between general pathologists and pathologists experienced in melanoma in terms of the evaluation of histopathological prognostic parameters in cutaneous malignant melanomas, and to what extent the putative variability affected clinical management. A total of 234 cases of invasive cutaneous malignant melanoma were included in the study from the Stockholm-Gotland Healthcare Region in Sweden. Overall interobserver variability between a general pathologist and an expert review was 68.8-84.8%. Approximately 15.5% of melanomas ≤1 mm were re-classified either as melanoma in situ or melanomas >1 mm after review. In conclusion, review by a pathologist experienced in melanoma resulted in a change in recommendations about surgical excision margins and/or sentinel node biopsy in subgroups of T1 melanomas.
authors.affiliation: Department of Medicine, Unit of Dermatology, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden. hanna.eriksson.4@ki.se
authors.forename: Hanna
authors.initials: H
authors.lastname: Eriksson
authors.forename: Margareta
authors.initials: M
authors.lastname: Frohm-Nilsson
authors.forename: Mari-Anne
authors.initials: MA
authors.lastname: Hedblad
authors.forename: Henrik
authors.initials: H
authors.lastname: Hellborg
authors.forename: Lena
authors.initials: L
authors.lastname: Kanter-Lewensohn
authors.forename: Kamilla
authors.initials: K
authors.lastname: Krawiec
authors.forename: Barbro
authors.initials: B
authors.lastname: Lundh Rozell
authors.forename: Eva
authors.initials: E
authors.lastname: Månsson-Brahme
authors.forename: Johan
authors.initials: J
authors.lastname: Hansson
mesh_terms: D002983:Clinical Competence; D006801:Humans; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015588:Observer Variation; D010336:Pathology / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D012883:Skin Ulcer / Q000473:pathology; D013548:Sweden; D047368:Tumor Burden