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.
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.
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DOI：
10.1186/1471-2407-10-150
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发表时间：
2010-04-19
期刊：
影响因子：
3.8
通讯作者：
Ray-Coquard I
中科院分区：
文献类型：
--
作者：
Lurkin A;Ducimetière F;Vince DR;Decouvelaere AV;Cellier D;Gilly FN;Salameire D;Biron P;de Laroche G;Blay JY;Ray-Coquard I
肉瘤是一种罕见的恶性肿瘤。准确的初步组织学诊断是必要的适当的管理。我们前瞻性地评估了一年内欧洲地区所有诊断为肉瘤的患者的医疗管理，以确定首次诊断与中央专家评审（CER）相比的数量。收集了2005年3月至2006年2月期间在罗纳-阿尔佩斯诊断为肉瘤的所有患者的组织学资料。初步诊断与区域和国家专家的第二意见进行了系统的比较。在纳入的448例患者中，366例（82%）符合入选标准并进行了分析。其中，199例（54%）的初步诊断和第二意见之间完全一致（第一病理学家和专家得出相同的结论），97例（27%）部分一致（相同的诊断结合肿瘤，但不同的级别或亚型），70例（19%）完全不一致（不同的组织学类型或肉瘤的诊断无效）。主要差异与组织学分级（n = 68，19%）、组织学类型（n = 39，11%）、亚型（n = 17，5%）和分级+亚型或分级+组织学类型（n = 43，12%）有关。超过45%的首次组织学诊断在第二次阅读时被修改，可能导致不同的治疗决策。系统的第二专家意见提高了诊断质量，并可能提高对患者的管理。
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.
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影响因子：
8.8
作者：
Harris, M;Hartley, A L;Blair, V;Birch, J M;Banerjee, S S;Freemont, A J;McClure, J;McWilliam, L J
通讯作者：
McWilliam, L J
影响因子：
2.4
作者：
Menegoz, F;Black, RJ;Schaffer, P
通讯作者：
Schaffer, P
影响因子：
22.4
作者：
FLEISS, JL;COHEN, J;EVERITT, BS
通讯作者：
EVERITT, BS
影响因子：
2.7
作者：
COHEN, J
通讯作者：
COHEN, J
影响因子：
2.5
作者：
Lehnhardt, Marcus;Daigeler, Adrien;Steinau, Hans Ulrich
通讯作者：
Steinau, Hans Ulrich