Missing parameters in malignant polyp histology reports: can appropriate decisions be made?

Area of Science:

• Oncology
• Pathology
• Gastroenterology

Background:

• Accurate histopathological reporting of colorectal malignant polyps is crucial for predicting residual disease and lymph node metastasis.
• The Royal College of Pathologists of Australasia (RCPA) established protocols for mandatory and recommended pathological parameters in malignant polyp reports.

Purpose of the Study:

• To evaluate the quality of pathological reporting for malignant polyps in Queensland, Australia, from 2011-2019.
• To assess the impact of incomplete reports on potential treatment strategies.

Main Methods:

• A retrospective population-wide cohort study using the Queensland Oncology Repository.
• Analysis of 1,646 histopathological reports against RCPA protocol standards.
• Calculation of missing parameters and their potential impact on patient management.

Main Results:

• 30.8% of reports had sufficient missing parameters to potentially alter management.
• Haggitt or Kikuchi level was the most frequently under-reported parameter (48.6%).
• Synoptic reporting significantly reduced missing parameters (p<0.001), and reporting quality improved over time (p<0.001).

Conclusions:

• Despite improvements, pathology reports for malignant polyps remain incomplete regarding essential parameters.
• Complete and accurate pathology reporting is vital for guiding surgical recommendations post-polyp resection.
• The introduction of RCPA protocols has led to a positive trend in reporting quality over the study period.