Epidemiological evaluation of concordance between initial diagnosis and central pathology review in a comprehensive and prospective series of sarcoma patients in the Rhone-Alpes region

• Published in: BMC cancer 2010-04, Vol.10 (1), p.150-150, Article 150
• Main Authors: Lurkin, Antoine, Ducimetière, Francoise, Vince, Dominique Ranchère, Decouvelaere, Anne-Valérie, Cellier, Dominic, Gilly, François N, Salameire, Dimitri, Biron, Pierre, de Laroche, Guy, Blay, Jean Yves, Ray-Coquard, Isabelle
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cancer; Case-Control Studies; Diagnosis; Epidemiologic methods; Experts; Female; France; France - epidemiology; Histology; Hospitals; Humans; International aspects; Life Sciences; Male; Middle Aged; Pediatrics; Physiology, Pathological; Prospective Studies; Sarcoma; Sarcoma - diagnosis; Sarcoma - epidemiology; Sarcoma - pathology; Young Adult
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/1471-2407-10-150

Sarcomas are rare malignant tumors. Accurate initial histological diagnosis is essential for adequate management. We prospectively assessed the medical management of all patients diagnosed with sarcoma in a European region over a one-year period to identify the quantity of first diagnosis compared to central expert review (CER). Histological data of all patients diagnosed with sarcoma in Rhone-Alpes between March 2005 and Feb 2006 were collected. Primary diagnoses were systematically compared with second opinion from regional and national experts. Of 448 patients included, 366 (82%) matched the inclusion criteria and were analyzed. Of these, 199 (54%) had full concordance between primary diagnosis and second opinion (the first pathologist and the expert reached identical conclusions), 97 (27%) had partial concordance (identical diagnosis of conjonctive tumor but different grade or subtype), and 70 (19%) had complete discordance (different histological type or invalidation of the diagnosis of sarcoma). The major discrepancies were related to histological grade (n = 68, 19%), histological type (n = 39, 11%), subtype (n = 17, 5%), and grade plus subtype or grade plus histological type (n = 43, 12%). Over 45% of first histological diagnoses were modified at second reading, possibly resulting in different treatment decisions. Systematic second expert opinion improves the quality of diagnosis and possibly the management of patients.