Processing of fallopian tube, ovary, and endometrial surgical pathology specimens: A survey of U.S. laboratory practices

Samimi, Goli; Trabert, Britton; Duggan, Máire A.; Robinson, Jennifer L.; Coa, Kisha; Waibel, Elizabeth; Garcia, Edna; Minasian, Lori M.; Sherman, Mark E.

doi:10.1016/j.ygyno.2018.01.016

Cited by 13 publications

(9 citation statements)

References 33 publications

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“…Although criteria for diagnosing STIC have been proposed, there is still significant interobserver disagreement. 6 In certain scenarios, frequency of STIC is difficult to determine, like in cases of metastases involving fallopian tube and mimicking STIC, interobserver variability, sampling or effacement of fallopian tube by large carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Detection of Serous Tubal Intraepithelial Carcinoma along with High Grade Serous Carcinoma of Both Ovaries

Tariq

2021

J Coll Physicians Surg Pak

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High-grade serous carcinoma (HGSC) of ovary is the commonest of all ovarian malignant tumours and is associated with high mortality rate. Serous tubal intraepithelial carcinoma (STIC) is believed to be the precursor lesion. In literature, only 40-50% of HGSC shows concurrent STIC, even after thorough sampling. We, herein, present a case of a 40-year female, who underwent staging laparotomy for bilateral ovarian carcinoma. She was diagnosed as HGSC of both ovaries. Left ovary capsule was focally ruptured. Peritoneal washings showed metastatic carcinoma. Provisional FIGO stage was IC. During sampling, concurrent finding of STIC was documented in right fallopian tube. No invasive carcinoma was present in both entirely submitted fallopian tubes.

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Section: Discussionmentioning

confidence: 99%

Detection of Serous Tubal Intraepithelial Carcinoma along with High Grade Serous Carcinoma of Both Ovaries

Tariq

2021

J Coll Physicians Surg Pak

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“…The paper states there is minimal evidence-based data that evaluate the health outcomes related to exempt status or gross only examination policies for specific specimens. Furthermore, institutions that performed more surgeries were found to have more exempt status tissues while teaching hospitals had less exempt status tissues in this study [2,6]. This may indicate that the medical benefit of pathologic examinations is overstated seeing as institutions with a higher caseload more often forgo the exam.…”

Section: Discussionmentioning

confidence: 77%

“…With the evidence presented in this review, the incidence of STIC has been reported in less than 1% of specimens removed for benign indications [6] and HGSC rates are low according to population risk. In one series of 522 average-risk women undergoing salpingectomy, only four cases were detected [12].…”

Section: Discussionmentioning

confidence: 89%

“…A recent increase in the incidence of early-stage tubal carcinoma is likely due to changing pathology protocols and the increase in the performance of salpingectomies in the United States. Currently, STIC is not a term in the Surveillance, Epidemiology and End Results Program (SEER) so true rates are difficult to interpret [6]. Still, the lack of effective screening for ovarian cancer points to the possibility of salpingectomy serving a prophylactic role and decreasing the incidence of ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

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Cost Analysis of Bilateral Salpingectomy Pathology for Women of Average Risk of Ovarian Cancer

2021

IJOG

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Bilateral salpingectomy has gained traction as a preferred form of surgical sterilization over tubal ligation due to the potential reduction in the risk of ovarian cancer. This paper argues it is safe and economical for the physician performing the salpingectomy in patients with an average risk of ovarian cancer to use clinical judgement in deciding whether the specimen should undergo gross and histologic examination. Implementing this new strategy could help decrease medical expenditures concerning surgical pathology by an estimated $10,075,980. Reducing costs and unnecessary strain on healthcare resources will improve the efficiency of medical systems and the quality of care they provide. Keywords: Cost-effectiveness; Health economics; Gynecologic pathology; Surgical pathology; Bilateral salpingectomy; Sterilization; Ovarian cancer; Serous tubal intraepithelial carcinoma

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“…The modified and full serial examination and embedding of the fimbriae (SEE-FIM) methods more comprehensively examine the fimbriated end of the fallopian tubes than the examination of one random section of the distal end (14). SEE-FIM increases the detection of serous tubal intraepithelial carcinoma (STIC) and early tubal serous carcinoma (15,16).…”

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confidence: 99%

Associations Between Intraluminal Tumor Cell Involvement in Serially Examined Fallopian Tubes and Endometrial Carcinoma Characteristics and Outcomes

Rodriquez

Felix

Brett

et al. 2021

International Journal of Gynecological Pathology

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Approximately 12% of routinely examined fallopian tubes of endometrial carcinoma (EC) cases have intraluminal tumor cells (ILTCs). ILTC associations with EC characteristics and outcomes are understudied, and unknown in serially examined and embedded tubal fimbriae. Glass slides of serially examined and embedded tubal fimbriae for 371 EC cases were independently reviewed by 2 pathologists who recorded ILTC presence and characterized them as mucosal if involved and floating if not. Disagreements were reviewed by a third pathologist, and agreement between any 2 determined final ILTC status. Clinico-pathologic associations and ILTC presence were tested for significance (P<0.05) by univariable analysis, and stage and histotype determinants were included in a multivariable analysis. The Kaplan-Meier estimates and log-rank tests compared overall and EC-specific survival, and Cox proportional regression estimated hazard ratios. ILTCs were present in 56 (15.1%) cases: 30 mucosal and 26 floating. FIGO stage 3/4, lymph-vascular space invasion, deep myometrial invasion, nonendometrioid histotype, and adjunctive chemotherapy were significantly associated with ILTC presence, and only stage was significant in the multivariable analysis. Overall, 61 women died: 30 of whom died of EC. ILTCs were nonsignificantly associated with higher overall and EC-specific mortality and mucosal ILTCs had the highest hazard ratios (1.64 and 1.89, respectively). Serially examined and embedded tubal fimbriae have a higher prevalence of ILTCs than routinely examined tubes, and high FIGO stage is an independent determinant. A prognostic effect was not found, but the higher trending hazard ratios suggest additional study is needed to determine whether ILTCs and in particular mucosal ILTCs adversely affect prognosis.

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Processing of fallopian tube, ovary, and endometrial surgical pathology specimens: A survey of U.S. laboratory practices

Cited by 13 publications

References 33 publications

Detection of Serous Tubal Intraepithelial Carcinoma along with High Grade Serous Carcinoma of Both Ovaries

Detection of Serous Tubal Intraepithelial Carcinoma along with High Grade Serous Carcinoma of Both Ovaries

Cost Analysis of Bilateral Salpingectomy Pathology for Women of Average Risk of Ovarian Cancer

Associations Between Intraluminal Tumor Cell Involvement in Serially Examined Fallopian Tubes and Endometrial Carcinoma Characteristics and Outcomes

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