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Abstract
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Introduction:
Soft tissue tumors are rare tumors and histological examination remains a challenge.The diagnostics and treatment planning of soft tissue tumors are critically dependent on the pathological examination.
The French sarcoma network has established the importance of secondary expert path reading by pathologists who see more than 300 tumors a year. In Switzerland, pathological analysis is established locally, and then sometimes secondarily reviewed by a reference pathologist. Herein, we assess the accuracy of the diagnosis from the local pathologist compared to the diagnosis from the reference pathologist.
Method:
We examine retrospectively all pathology reports from a Swiss referral center between January 2019 and December 2020. All reports were presented at the SwissSarcomaBoard and were reviewed secondarily by the reference pathologist. Patients with incomplete records were excluded. We categorized the accuracy in groups A, B and C, according to the classification which was presented 2014 in „sarcoma“ (1). Cases without no discrepancy in diagnosis were classified under category A. Category B includes cases with minor discrepancy in diagnosis with no therapeutic consequences. Category C contains all cases, where the diagnosis from the reference pathologist changed the treatment.
Results:
196 patients with a biopsy as a prime diagnosis were included in the study. Overall, category A comprised 149 patients (76.4%), category B 21 patients (10.8%) and C 25 patients (12.8%).
Analysis of malignant tumors, makes the discrepancies even more pronounced compared to the overall results.
Conclusion:
The pathological examination of soft tissue tumors by an expert pathologist is highly recommended, as in 16% from all malignant biopsies there is a significant change in the therapy after expert review
References:
1. THWAY, Khin, et al. Histopathological diagnostic discrepancies in soft tissue tumours referred to a specialist centre: reassessment in the era of ancillary molecular diagnosis. Sarcoma, 2014, 2014. Jg.
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