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Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions

2012; Elsevier BV; Volume: 23; Issue: 9 Linguagem: Inglês

10.1093/annonc/mdr610

1569-8041

I. Ray-Coquard, Maria Cristina Montesco, Jean‐Michel Coindre, Angelo Paolo Dei Tos, A. Lurkin, Dominique Ranchère‐Vince, Antonella Vecchiato, A.V. Decouvelaere, Simone Mathoulin‐Pélissier, Sabrina Albert, Philippe Cousin, Dominic Cellier, Luisa Toffolatti, Carlo Riccardo Rossi, Jean‐Yves Blay,

Tumors and Oncological Cases

BackgroundSarcomas represent a heterogeneous group of tumors. Accurate determination of histological diagnosis and prognostic factors is critical for the delineation of treatment strategies. The contribution of second opinion (SO) to improve diagnostic accuracy has been suggested for sarcoma but has never been established in population-based studies.MethodsHistological data of patients diagnosed with sarcoma in Rhone-Alpes (France), Veneto (Italy) and Aquitaine (France) over a 2-year period were collected. Initial diagnoses were systematically compared with SO from regional and national experts.ResultsOf 2016 selected patients, 1463 (73%) matched the inclusion criteria and were analyzed. Full concordance between primary diagnosis and SO (the first pathologist and the expert reached identical conclusions) was observed in 824 (56%) cases, partial concordance (identical diagnosis of connective tumor but different grade or histological subtype) in 518 (35%) cases and complete discordance (benign versus malignant, different histological type or invalidation of the diagnosis of sarcoma) in 121 (8%) cases. The major discrepancies were related to histological grade (n = 274, 43%), histological type (n = 144, 24%), subtype (n = 18, 3%) and grade plus subtype or grade plus histological type (n = 178, 29%).ConclusionMore than 40% of first histological diagnoses were modified at second reading, possibly resulting in different treatment decisions.