Related Experiment Video
Updated: Sep 1, 2025
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Prioritizing Patient Safety and Minimizing Waste: Institutional Review of Cases and a Proposed Process for Designing
Cynthia K Harris1, Alexander Pyden2, Allison M Onken3
1Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
Objectives:
Gross-only examination policies vary widely across pathology departments. Several studies-particularly a College of American Pathologists' Q-Probes study-have looked at the variations in gross-only policies, and even more studies have addressed the (in)appropriateness of certain specimen types for gross-only examination. Few, if any, studies have tackled the important task of how to revise and safely implement a new gross-only examination protocol, especially in collaboration with clinical colleagues.
Methods:
We reviewed the grossing protocols from three anatomic pathology centers to identify common gross-only specimen types. We compiled an inclusive list of any specimen types that appeared on one or more centers' lists. We performed a retrospective review of the gross and microscopic diagnoses for those specimen types to determine if any diagnoses of significance would have been missed had that specimen been processed as a gross-only.
Results:
We reviewed 940 cases among 13 specimen types. For 7 specimen types, the gross diagnoses provided equivalent information to the microscopic diagnoses. For 6 specimen types, microscopic diagnoses provided clinically meaningful information beyond what was captured in the gross diagnoses.
Conclusions:
To improve the value of care provided, pathology departments should conduct internal reviews and consider transitioning specimen types to gross-only when safe.
