Value of Supraregional Multidisciplinary Review for the Contemporary Management of Testicular Tumors

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• 作者：Karin Purshouse¹ ; Robert A. Watson¹ ; David N. Church¹ ; ² ; ^{dchurch@well.ox.ac.uk} ; Charlotte Richardson¹ ; Gemma Crane¹ ; Zoe Traill³ ; Mark Sullivan⁴ ; Ian Roberts⁵ ; Lisa Browning⁵ ; Gareth Turner⁵ ; Vishnu Parameshwaran¹ ; ⁵ ; Joseph Johnson¹ ; Meenali Chitnis¹ ; Andrew Protheroe¹ ; Clare Verrill⁵
• 关键词：Germ cell tumor ; Histopathology review
• 刊名：Clinical Genitourinary Cancer
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：15
• 期：1
• 页码：152-156
• 全文大小：216 K
• 卷排序：15

文摘

Testicular cancers are an uncommon and highly curable group of tumors that are typically managed by specialist multidisciplinary teams (MDTs). Although recent guidelines have emphasized the importance of tumor prognostic factors in predicting recurrence and personalizing therapy in early-stage disease, the role of central pathology review in determining these factors is unclear.Patients and MethodsWe compared the referral histopathology reports with those obtained after expert central review for all cases reviewed by the UK Thames Valley Cancer Network testicular tumor MDT from August 2004 to September 2012. For cases in which the findings differed, we recorded the effect of the alteration on the estimates of patient prognosis and predicted clinical management using international (European Society of Medical Oncology [ESMO]) and local guidelines.ResultsThe histopathology reports were altered after central review in 129 of 465 cases (27.7%) referred to the testicular tumor MDT during the study period. These resulted in changes in the estimation of prognosis for 42 patients (9.0% total), with a predicted affect on management according to the ESMO guidelines in 30 cases (6.5%). These proportions were broadly similar for both seminoma and nonseminoma, although the reasons for the discrepancies differed between the 2 (principally errors in categorization of rete testis invasion in seminoma and of lymphovascular invasion in nonseminoma). Changes to the tumor type were uncommon (2 cases).ConclusionCentral MDT review results in frequent, clinically relevant alterations to testicular tumor histopathology reports for testicular tumors. The results of our study demonstrate the importance of specialist MDTs to inform patient-centered care and ensure best practice in the management of these uncommon cancers.