Pathology reporting in head and neck cancer--snapshot of current status.

Abstract

Currently there is no standardized head and neck pathology reporting system in Victoria, Australia. The aim of this study was to document deficiencies in head and neck pathology reports at our institution. The pathology reports of all patients with head and neck squamous cell carcinoma (HNSCC) who presented to Peter MacCallum Cancer Centre for postoperative radiotherapy (PORT) between January 1, 2004, and March 31, 2006, were critically assessed for 16 key pathological items. Only 37% reports contained all the 16 items. The most commonly missing items were "diameter of the largest involved lymph node" (38%), "presence/absence of lymphovascular space invasion" (30%), "presence/absence of peri-neural invasion" (28%), "clearance of margins in millimeters" (27%), and "presence/absence of extracapsular extension" (27%). The most variable item was the clearance in millimeters used to determine "clear margins". Several of the most important pathological factors predicting locoregional relapse in HNSCC are currently the least reliably reported items in head and neck pathology reports.