Clinical Implication of Diagnostic and Histopathologic Discrepancies in Sinonasal Malignancies.
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma
/ diagnosis
Carcinoma, Neuroendocrine
/ diagnosis
Child
Child, Preschool
Diagnostic Errors
/ prevention & control
Female
Humans
Incidence
Kaplan-Meier Estimate
Male
Maxillary Sinus Neoplasms
/ diagnosis
Middle Aged
Neoplasm Staging
Paranasal Sinus Neoplasms
/ diagnosis
Paranasal Sinuses
/ pathology
Referral and Consultation
/ statistics & numerical data
Retrospective Studies
Sarcoma
/ diagnosis
Young Adult
Sinonasal malignancy
diagnostic error
discrepant diagnosis
histopathologic discrepancy
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
14
08
2020
received:
29
04
2020
accepted:
25
08
2020
pubmed:
19
9
2020
medline:
11
5
2021
entrez:
18
9
2020
Statut:
ppublish
Résumé
To evaluate the incidence of histopathologic diagnostic discrepancy for patients referred to our institution, identify pathologies susceptible to diagnostic error, and assess the impact on survival of histopathologic diagnostic discrepancies. Three hundred ninety-seven patients with sinonasal cancers were identified, and discordance between the outside pathologic report and MD Anderson Cancer Center pathologic report was assessed. Overall survival and disease-specific survival were analyzed using Kaplan-Meier and log rank methods. Discordance of major histopathologic diagnoses was present in 24% (97 of 397) of reports, with sinonasal undifferentiated carcinoma, sarcoma, neuroendocrine carcinoma, and poorly differentiated carcinoma pathologies having the highest change in diagnosis (P < .01). A further 61% (244 of 397) had minor changes such as histologic grade, subtype, or stage, with sarcoma and neuroendocrine carcinoma pathologies being most susceptible to change (P < .02). Overall, the 5-year overall survival (OS) and disease-specific survival (DSS) was reduced in patients with a major change in histopathologic diagnosis (59.2% vs. 70.2% (P = .02) and 72.9% vs. 81.2% (P = .02), respectively). Furthermore, patients with a major change in diagnosis and prior treatment experienced a significant reduction in 5-year OS (61.9% vs. 70.4%, P = .03 < .01) and DSS (72.4% vs. 81.5%, P = .04). Histopathological diagnosis of sinonasal tumors is complex and challenging given the rarity of the disease. Obtaining the correct diagnosis is important for treatment selection and survival. In histologies prone to misdiagnoses, obtaining a second opinion from experienced head and neck pathologists at a high-volume institution may potentially lead to a change in treatment recommendations that could result in improved survival in patients with sinonasal malignancies. 4 Laryngoscope, 131:E1468-E1475, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E1468-E1475Informations de copyright
© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
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