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Should centralised histopathological review in penile cancer be the global standard?
MedLine Citation:
PMID:  24053106     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: ● To assess the role of centralised pathology review in penile cancer management.
MATERIALS AND METHODS: ● Newly diagnosed squamous cell carcinomas (SCC) of the penis, including squamous cell carcinoma-in-situ (CIS) from biopsy specimens that were referred from fifteen centres, to the regional Sn-MDT between 1(st) January 2008 and 30(th) March 2011 were included. ● Biopsy histology reports and slides, from the respective referring hospitals were reviewed by the Sn-MDT pathologists. ● The biopsy specimens' histological type, grade and stage reported by the Sn-MDT pathologist were compared with the referring hospital pathology report, as well as definitive surgery histology. ● The changes in histological diagnosis were further sub-divided into critical changes (i.e. could alter management) and non-critical changes (i.e. would not affect management).
RESULTS: ● 155 cases of SCC or CIS of the penis were referred from 15 different centres in North West England. ● After Sn-MDT histology review, the histological diagnosis was changed in 31% of cases and found to be statistical significant. 60.4% of the changes were deemed to be critical changes that resulted in a significant change in management. ● When comparing the initial biopsy histology, as reported by the Sn-MDT to the final histology from the definitive surgical specimens, it showed generally a good correlation.
CONCLUSIONS: ● In this study a significant proportion of penile cancer histology reports were revised following review in the Sn-MDT. Many of these changes altered patient management. ● This provides evidence that accurate pathological diagnosis plays a crucial role in determining the correct treatment and maximising the potential for good clinical outcomes in penile cancer. ● In the case of histopathology, centralisation has increased exposure to penile cancer and diagnostic accuracy, and should therefore be considered the gold standard.
Authors:
V Tang; L Clarke; Z Gall; Jh Shanks; D Nonaka; Nj Parr; Pa Elliott; Nw Clarke; V Ramani; Mw Lau; Vk Sangar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-5
Journal Detail:
Title:  BJU international     Volume:  -     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
Affiliation:
The Christie NHS Foundation Trust, UK.
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