Quality Assessment of Gallbladder Cancer Pathology Reports: A Dutch Nationwide Study

Abstract

Adequate reporting of pathological findings is essential for optimal patient management and to perform high-quality research. The aim of this study was to assess the completeness of pathology reports of gallbladder cancer (GBC) at the nationwide level to assess guideline adherence and make recommendations for improvement. A retrospective population-based cohort of GBC patients diagnosed in the Netherlands from 2000 to 2019 was collected using data from the Dutch Cancer Registry and the nationwide network and registry of histology. Pathology reports were scored on the presence and content of essential and optional items according to the Dutch consensus-based guideline on biliary tract cancer. By histopathological review of cases, we compared findings with the conclusion of the corresponding pathology report. All pathology reports (n = 849) had a narrative, nonstructured format. Overall completeness was low. Information on key prognostic factors, such as tumor side (hepatic vs. serosal), status of cystic duct and liver surgical margins and venous and perineural invasion, was frequently lacking (80%, 23%, 59%, 74% and 74% missing, respectively). Whereas certain items were often missing from the report, they could be retrospectively detected in a substantial proportion of cases during pathology review (n = 738). In conclusion, significant improvements could be made in the reporting of GBC in the Netherlands. Synoptic reporting could greatly enhance the completeness of reports, as already demonstrated for tumor types.

Keywords: completeness; narrative; pathology report; surgical pathology.

Figure 1

Comparison of pathology reports with pathology review before and after the update of the Dutch consensus guideline in 2013. For 738/849 cases, histopathological characteristics were reviewed by a pathology team, and results were compared with those from the report. In a large proportion of cases, data were missing from the original pathology report. A significant increase in concordance (report and review both “Yes” or both “No”) for all three types of invasion was observed after introduction of the consensus guideline in 2013, mainly due to a decrease in missing values. Results were analyzed by two-tailed Pearson’s Χ²-test. *: p < 0.05.