Reported discrepancy rates after pathology review of surgical pathology specimen varies widely from 1.3% to as high as 80%. A combained review of clinical, pathological and laboratory parameters in an oncopathological meeting would be way forward in this scenario. The purpose of this study was to assess the frequency of discordant diagnoses and to determine whether these contributed to a change in the treatment descision.
Prospective data of all patients discussed during the onco pathological meetings between march 2012 to march 2015 were included for the study.The cases for oncopathological meeting was selected by the clinicians at the department of medical oncology whenever there were discordance between clinical scenario and pathological diagnosis.We compared the first histopathological diagnosis with the second opinion and the changes made in treatment for all patients.Cases were counted as having a change in diagnosis only when the difference in diagnosis resulted in a significant change in therapy or prognosis.
A total of 362 cases were discussed and analyzed inthe clinicopathological meeting. 147 cases (40.60%) were haematological malignancies and 216 cases (59.66%) were solid tumours.Discussions were held on 614 pathological specimen, 354 biopsies, 64 cytology and 196 bone marrow studies. There were (27 of 362 patients)7.45% clinically significant disconcordance between the first report and the results after an oncopathological discussion . The discordance was 6.80% for heamato lymphoid malignancies and 7.87 % for solid tumors. Follow up details of 24 patients are available and in all the occasions the clinical behaviour of the disease correlated with the review diagnosis made at the oncopathology meeting.
|Change||Heamato lymphoid N = 10||Solid tumor N = 17|
|Primary histological type||6||11|
|Malignant to benign||1||2|
|Benign to malignant||0||1|
|Margin status changed||0||1|
The clinico pathological meetings definitely impact the treatment decison and outcomes. Clinico pathological meetings should be a part of all multidisciplinary boards.
Clinical trial identification
All authors have declared no conflicts of interest.