title: The Added Value of Pathology Review in Vulvar Cancer: Results From a Population-based Cohort Study.
abstract: We conducted a population-based patterns of care study of vulvar carcinoma. This paper describes the changes in reporting based on pathology review. This is a retrospective population-based cohort study. We obtained all pathology records available from the provincial cancer registry for primary invasive squamous cell carcinoma of the vulva diagnosed between 1998 and 2007. Pathology reviews were conducted centrally by a group of gynecologic pathologists and were identified during abstraction. Corresponding original reports were matched to pathology review reports based on accession numbers. We compared the reported value for presence/absence of invasion, grade, depth, thickness, size, lymphovascular space invasion, peripheral margin status, and deep margin status in the original and review report. A total of 1011 vulvar resection reports were identified. From these, we identified 316 pairs of original/review reports. Missing data were common but improved in the reviews. In total, 55 (17%) reports had at least 1 change from the original to the review based on presence of invasion, depth, lymphovascular space invasion, or margin. When we included reports where a variable was missing in the original but then completed in the review, there were clinically relevant changes in 210 reports (66%). Vulvar carcinoma is a rare diagnosis and pathology reviews resulted in potentially important clinical changes in a significant proportion of cases. Referral pathologists play an important role in contributing to high-quality clinical decisions.
authors: Departments of Radiation Oncology (L.B., G.T., A.F., E.R.) Obstetrics and Gynecology (L.T.G., A.C., A.F.), Division of Gynecologic Oncology Health Policy, Management and Evaluation (R.S., E.R.) Dalla Lana School of Public Health (R.S.), University of Toronto Institute for Clinical Evaluative Sciences (L.B., L.T.G., R.S., E.R., Y.L.), Toronto Department of Obstetrics and Gynecology (L.E.), Division of Gynecologic Oncology, McMaster University, Hamilton, ON, Canada Department of Lab Medicine and Pathology (M.K.), University of Minnesota, Minneapolis, MN.
authors: Lisa
authors: L
authors: Barbera
authors: Lilian T
authors: LT
authors: Gien
authors: Rinku
authors: R
authors: Sutradhar
authors: Gillian
authors: G
authors: Thomas
authors: Al
authors: A
authors: Covens
authors: Laurie
authors: L
authors: Elit
authors: Anthony
authors: A
authors: Fyles
authors: Eileen
authors: E
authors: Rakovitch
authors: Ying
authors: Y
authors: Liu
authors: Mahmoud
authors: M
authors: Khalifa
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010338:Pathology, Clinical / Q000379:methods*; D012017:Referral and Consultation; D012189:Retrospective Studies; D014846:Vulvar Neoplasms / Q000473:pathology*