The effects of implementing synoptic pathology reporting in cancer diagnosis: a systematic review

Abstract

Pathology reporting is evolving from a traditional narrative report to a more structured synoptic report. Narrative reporting can cause misinterpretation due to lack of information and structure. In this systematic review, we evaluate the impact of synoptic reporting on completeness of pathology reports and quality of pathology evaluation for solid tumours. Pubmed, Embase and Cochrane databases were systematically searched to identify studies describing the effect of synoptic reporting implementation on completeness of reporting and quality of pathology evaluation of solid malignant tumours. Thirty-three studies met the inclusion criteria. All studies, except one, reported an increased overall completeness of pathology reports after introduction of synoptic reporting (SR). Most frequently studied cancers were breast (n = 9) and colorectal cancer (n = 16). For breast cancer, narrative reports adequately described ‘tumour type’ and ‘nodal status’. Synoptic reporting resulted in improved description of ‘resection margins’, ‘DCIS size’, ‘location’ and ‘presence of calcifications’. For colorectal cancer, narrative reports adequately reported ‘tumour type’, ‘invasion depth’, ‘lymph node counts’ and ‘nodal status’. Synoptic reporting resulted in increased reporting of ‘circumferential margin’, ‘resection margin’, ‘perineural invasion’ and ‘lymphovascular invasion’. In addition, increased numbers of reported lymph nodes were found in synoptic reports. Narrative reports of other cancer types described the traditional parameters adequately, whereas for ‘resection margins’ and ‘(lympho)vascular/perineural invasion’, implementation of synoptic reporting was necessary. Synoptic reporting results in improved reporting of clinical relevant data. Demonstration of clinical impact of this improved method of pathology reporting is required for successful introduction and implementation in daily pathology practice.Electronic supplementary materialThe online version of this article (doi:10.1007/s00428-016-1935-8) contains supplementary material, which is available to authorized users.

Significant inter‐ and intra‐laboratory variation in grading of invasive breast cancer: A nationwide study of 33,043 patients in the Netherlands

“…As synoptic reporting, compared to narrative reporting, results in an increased overall completeness of pathology reports, and as it enables easy data extraction because all variables are stored in a standardized manner, data included in this study were solely from synoptically reported IBC lesions. Currently, over 80 percent of (pre)malignant breast lesions is reported via the synoptic PALGA protocol by pathologists in the Netherlands .…”

The utility of thyroid ultrasonography in the management of thyroid nodules

“…In varied settings, including thyroid cancer and pancreatic cancer, synoptic reporting has been examined by international studies and validated as a method for capturing clinical data and improving patient outcomes. [29][30][31] Technological advances have made ultrasonography more accessible, and surgeon-directed assessments are now significantly more likely to drive interventions. 32,33 In fact, the lack of standardized reporting is driving the increased uptake of ultrasonog raphy among surgeons owing to the varied quality of reports, and this trend is accelerating.…”

Electronic tumor board presentations as the basis for the development of a head and neck cancer database

“…What started as a basic TB e‐form gradually expanded to include granular details but was specifically kept from being unwieldy by using branching logic for specific entries and limiting free‐text sections. Synoptic reporting has replaced traditional free‐text to ensure the repeated completeness of data documentation in a consistent scientific format and has gained acceptance in various fields, such as radiology, pathology, and operative surgery . It was hence a logical reporting choice to guide TB data entry due to the complexity of HNC patient data.…”