Background: Appropriate histopathology reporting helps to ensure effective therapy and prognosis. Objective: Toexamine compliance with clinical practice guidelines for histopathology reports of melanomas. Methods: A sample of melanoma histopathology reports in Queensland was audited for inclusion of recommended information. The quality of documentation was constructed and multivariate analysis used to determine factors affecting the quality of reporting practices. Results: Documentation of the most important features of melanoma was high: clear diagnosis (99.8%; 95% CI 98.6–100), thickness (99.8%; 95% CI 98.6–100), comment on adequacy of excision (87.9%; 95% CI 84.9–91.0) and measurement of margins (91.9%; 95% CI 88.8–91.4). Overall reporting of ulceration and regression was of lesser completeness (83.0 and 77.8%, respectively) and these features were more likely to be reported by high-volume laboratories (p < 0.001 and p = 0.037, respectively). This trend was not apparent for other features. Fewer than 50% of reports documented mitotic rate per square millimetre, predominant cell type, microsatellites, growth phase and desmoplasia. Conclusion: Awareness of current reporting practices and identification of areas in which insufficiencies exist enable the revision of systems and potential improvements to the transfer of information to treating clinicians.

Keywords:
Melanoma, Histopathology report, Clinical practice guidelines, Laboratory melanoma reporting volume
1.
Gloster HM Jr, Brodland DG: The epidemiology of skin cancer. Dermatol Surg 1996;22:217–226.
2.
The Australian Cancer Network: Clinical Practice Guidelines for the Management of Cutaneous Melanoma. Canberra, National Health and Medical Research Council, 1999.
3.
Metcalf JS: Melanoma: criteria for histological diagnosis and its reporting. Semin Oncol 1996;23:688–692.
4.
Marghoob AA, Koenig K, Bittencourt FV, Kopf AW, Bart RS: Breslow thickness and Clark level in melanoma: support for including level in pathology reports and in American Joint Committee on Cancer Staging. Cancer 2000;88:589–595.
5.
Kaur MR, Colloby PS, Martin-Clavijo A, Marsden JR: Melanoma histopathology reporting: are we complying with the National Minimum Dataset? J Clin Pathol 2007;60:1121–1123.
6.
Australian Institute of Health and Welfare, Australasian Association of Cancer Registries. Cancer in Australia 2001. Canberra, Australian Institute of Health and Welfare, Australasian Association of Cancer Registries, 2004.
7.
Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB: Cancer Incidence in Five Continents, vol 8. Lyon, IARC Publ No 155, 2003.
8.
Calonje E: ACP best practice, No 162. The histological reporting of melanoma. Association of Clinical Pathologists. J Clin Pathol 2000;53:587–590.
9.
Stata Corporation: Stata statistical software, version 9.2. College Station, Stata Corporation, 2006.
10.
Maheshwari M, Read-Jones S: Audit of malignant melanoma histopathology reports. Birmingham, Royal College of Pathologists, 2006.
11.
Australian Institute of Health and Welfare, Australasian Association of Cancer Registries. Cancer in Australia, an overview, 2006. Canberra, Australian Institute of Health and Welfare, Australasian Association of Cancer Registries, 2007.
12.
Shaikh L, Sagebiel RW, Ferreira CM, Nosrati M, Miller JR 3rd, Kashani-Sabet M: The role of microsatellites as a prognostic factor in primary malignant melanoma. Arch Dermatol 2005;141:739–742.
13.
Francken AB, Shaw HM, Thompson JF, Soong S-J, Accortt NA, Azzola MF, Scolyer RA, Milton GW, McCarthy WH, Colman MH, McGovern VJ: The prognostic importance of tumor mitotic rate confirmed in 1,317 patients with primary cutaneous melanoma and long follow-up. Ann Surg Oncol 2004;11:426–433.
14.
Cook MG: Diagnostic discord with melanoma. J Pathol 1997;182:247–249.
15.
Scolyer RA, Shaw HM, Thompson JF, Li LX, Colman MH, Lo SK, McCarthy SW, Palmer AA, Nicoll KD, Dutta B, Slobedman E, Watson GF, Stretch JR: Interobserver reproducibility of histopathologic prognostic variables in primary cutaneous melanomas. Am J Surg Pathol 2003;27:1571–1576.
16.
Cook MG, Clarke TJ, Humphreys S, Fletcher A, McLaren KM, Smith NP, Stevens A, Theaker JM, Melia J: The evaluation of diagnostic and prognostic criteria and the terminology of thin cutaneous malignant melanoma by the CRC Melanoma Pathology Panel. Histopathology 1996;28:497–512.
17.
Lefevre M, Vergier B, Balme B, Thiebault R, Delaunay M, Thomas L, Beylot-Barry M, Machet L, De Muret A, Bioulac-Sage P, Bailly C: Relevance of vertical growth pattern in thin level II cutaneous superficial spreading melanomas. Am J Surg Pathol 2003;27:717–724.
18.
Grande Sarpa H, Reinke K, Shaikh L, Leong SP, Miller JR 3rd, Sagebiel RW, Kashani- Sabet M: Prognostic significance of extent of ulceration in primary cutaneous melanoma. Am J Surg Pathol 2006;30:1396–1400.
19.
Balch CM, Soong SJ, Gershenwald JE, Thompson JF, Reintgen DS, Cascinelli N, Urist M, McMasters KM, Ross MI, Kirkwood JM, Atkins MB, Thompson JA, Coit DG, Byrd D, Desmond R, Zhang Y, Liu PY, Lyman GH, Morabito A: Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001;19:3622–3634.
20.
Busam KJ: Lack of relevant information for tumor staging in pathology reports of primary cutaneous melanoma. Am J Clin Pathol 2001;115:743–746.
21.
Crowson AN, Magro CM, Mihm MC: Prognosticators of melanoma, the melanoma report, and the sentinel lymph node. Mod Pathol 2006;19(suppl 2):S71–S87.
22.
Scolyer RA, Thompson JF, Stretch JR, Sharma R, McCarthy SW: Pathology of melanocytic lesions: new, controversial, and clinically important issues. J Surg Oncol 2004;86:200–211.
23.
Thompson JF, Scolyer RA: Cooperation between surgical oncologists and pathologists: a key element of multidisciplinary care for patients with cancer. Pathology 2004;36:496–503.
24.
Liu V, Mihm MC: Pathology of malignant melanoma. Surg Clin North Am 2003;83:31–60.
25.
Powsner SM, Costa J, Homer RJ: Clinicians are from Mars and pathologists are from Venus. Arch Pathol Lab Med 2000;124:1040–1046.
26.
Karim RZ, van den Berg KS, Colman MH, McCarthy SW, Thompson JF, Scolyer RA: The advantage of using a synoptic pathology report format for cutaneous melanoma. Histopathology 2008;52:130–138.
27.
Miller JM, Slater DN: Do histopathology reports of primary cutaneous melanoma contain enough essential information? J Clin Pathol 1996;49:202–204.
© 2008 S. Karger AG, Basel
2008
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.