Synoptic pathology reporting for thyroid cancer: a review and institutional experience

Abstract

Thyroid cancer surgical pathology reports contain information that is critical for diagnosis, determining completeness of resection, staging and guiding postoperative management. Traditional narrative pathology reporting is prone to errors and omissions with variability in content and completeness. The objective of this review was to evaluate the impact of synoptic reporting on thyroid cancer pathology reporting. Our institutional study of pathology reporting of differentiated thyroid cancers at a Canadian tertiary care institution relative to the College of American Pathologists checklists is also presented and critically evaluates deficiencies in the narrative pathology reporting format.

Keywords::

• pathology reporting
• synoptic report
• thyroid cancer

Financial & competing interests disclosure

The authors have no affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Cancer pathology reports in synoptic format are more consistent, accurate, complete and easier to decipher when compared with reports presented in a narrative style.

• • Synoptic reporting minimizes the risk of misinterpretation, reduces error, saves time and facilitates communication and research.

• • Information provided by thyroid cancer pathology reports is essential for patient management and clinical decision-making. The presence of specific elements in pathology reports are essential for deciding whether adjuvant therapy or additional surgery is necessary, and what type and frequency of disease surveillance and postsurgical follow-up is most appropriate. Inconsistencies and omissions in cancer pathology reporting may lead to treatment delays and incomplete or inappropriate postoperative management and adversely impact patient outcome.

• • Computerized systems based upon predetermined, validated cancer pathology checklists, such as the College of American Pathologists Cancer Protocol checklists, may facilitate synoptic reporting and improve clinical decision-making, data abstraction and communication.