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[Impact of pathological review by an expert on the diagnosis and management of patients with cancer in Aquitania].
Ann Pathol. 2008 Dec; 28(6):478-85.AP

Abstract

AIMS

The goal of this work was to evaluate the impact of expert pathological second opinion on the diagnosis and management of patients with cancer, in a French region (Aquitaine) and with an economic point of view.

MATERIAL AND METHODS

The study was first quantitative, performed retrospectively on all cases of cancer, voluntary sent for a second opinion to an expert pathologist of two centers. Secondly, we restricted the study to lymphoid, melanocytic and soft tissue tumors sent for second opinion. We considered that the expert review had an important diagnostic impact either when the initial pathologist sent the specimen to identify or classify malignant tumor or hesitated between benign and malignant tumor or had no hypothesis, or if there were discordant diagnoses (malignant/benign) between the two pathologists. We considered that the expert review had a high therapeutic impact if the disagreement between initial and expert diagnoses induced a complete modification in therapy. We evaluated the cost of second opinion for the expert centers and the cost of care management.

RESULTS

Over the year 2006, the expert centers received 5077 lesions for consultation: 3769 specimens were sent by a pathologist for a second review, 1324 by pathologists of Aquitania and of these, 751 samples were submitted for lymphoid (55%), soft tissues (30%) or melanocytic tumors (15%). There was an important diagnostic impact for 75% of the samples; the impact of the expert review on patient management was considered high for 46% of specimens and the expert pathological diagnosis modified the clinical prognosis for 40% of the specimens. We estimated that for 53 discordant diagnoses (malignant/benign), second opinion allowed an economy of 500,000 euro.

CONCLUSION

Expert second opinion is very important not only for diagnosis and management for patient with cancer but also for economic reasons.

Links

Publisher Full Text

Authors+Show Affiliations

Lapeyrere N
Réseau de cancérologie d'Aquitaine, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
Parrens M
No affiliation info available
Coindre JM
No affiliation info available
Soubeyran I
No affiliation info available
de Mascarel A
No affiliation info available
Merlio JP
No affiliation info available
Lebail B
No affiliation info available
Lepreux S
No affiliation info available
Jaffre A
No affiliation info available
Gilleron V
No affiliation info available
Mathoulin-Pélissier S
No affiliation info available
Vergier B
No affiliation info available
le Groupe des anatomopathologistes Aquitains
No affiliation info available

MeSH

Cost of IllnessDiagnosis, DifferentialExpert TestimonyFranceHumansImmunohistochemistryLymphomaMelanomaNeoplasmsPathologyRetrospective StudiesSarcoma

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

19084716

Citation

Lapeyrere, Nadège, et al. "[Impact of Pathological Review By an Expert On the Diagnosis and Management of Patients With Cancer in Aquitania]." Annales De Pathologie, vol. 28, no. 6, 2008, pp. 478-85.
Lapeyrere N, Parrens M, Coindre JM, et al. [Impact of pathological review by an expert on the diagnosis and management of patients with cancer in Aquitania]. Ann Pathol. 2008;28(6):478-85.
Lapeyrere, N., Parrens, M., Coindre, J. M., Soubeyran, I., de Mascarel, A., Merlio, J. P., Lebail, B., Lepreux, S., Jaffre, A., Gilleron, V., Mathoulin-Pélissier, S., & Vergier, B. (2008). [Impact of pathological review by an expert on the diagnosis and management of patients with cancer in Aquitania]. Annales De Pathologie, 28(6), 478-85. https://doi.org/10.1016/j.annpat.2008.09.044
Lapeyrere N, et al. [Impact of Pathological Review By an Expert On the Diagnosis and Management of Patients With Cancer in Aquitania]. Ann Pathol. 2008;28(6):478-85. PubMed PMID: 19084716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Impact of pathological review by an expert on the diagnosis and management of patients with cancer in Aquitania]. AU - Lapeyrere,Nadège, AU - Parrens,Marie, AU - Coindre,Jean-Michel, AU - Soubeyran,Isabelle, AU - de Mascarel,Antoine, AU - Merlio,Jean-Philippe, AU - Lebail,Brigitte, AU - Lepreux,Sébastien, AU - Jaffre,Anne, AU - Gilleron,Véronique, AU - Mathoulin-Pélissier,Simone, AU - Vergier,Béatrice, AU - ,, Y1 - 2008/11/17/ PY - 2008/09/26/accepted PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/2/27/medline SP - 478 EP - 85 JF - Annales de pathologie JO - Ann Pathol VL - 28 IS - 6 N2 - AIMS: The goal of this work was to evaluate the impact of expert pathological second opinion on the diagnosis and management of patients with cancer, in a French region (Aquitaine) and with an economic point of view. MATERIAL AND METHODS: The study was first quantitative, performed retrospectively on all cases of cancer, voluntary sent for a second opinion to an expert pathologist of two centers. Secondly, we restricted the study to lymphoid, melanocytic and soft tissue tumors sent for second opinion. We considered that the expert review had an important diagnostic impact either when the initial pathologist sent the specimen to identify or classify malignant tumor or hesitated between benign and malignant tumor or had no hypothesis, or if there were discordant diagnoses (malignant/benign) between the two pathologists. We considered that the expert review had a high therapeutic impact if the disagreement between initial and expert diagnoses induced a complete modification in therapy. We evaluated the cost of second opinion for the expert centers and the cost of care management. RESULTS: Over the year 2006, the expert centers received 5077 lesions for consultation: 3769 specimens were sent by a pathologist for a second review, 1324 by pathologists of Aquitania and of these, 751 samples were submitted for lymphoid (55%), soft tissues (30%) or melanocytic tumors (15%). There was an important diagnostic impact for 75% of the samples; the impact of the expert review on patient management was considered high for 46% of specimens and the expert pathological diagnosis modified the clinical prognosis for 40% of the specimens. We estimated that for 53 discordant diagnoses (malignant/benign), second opinion allowed an economy of 500,000 euro. CONCLUSION: Expert second opinion is very important not only for diagnosis and management for patient with cancer but also for economic reasons. SN - 0242-6498 UR - https://www.unboundmedicine.com/medline/citation/19084716/[Impact_of_pathological_review_by_an_expert_on_the_diagnosis_and_management_of_patients_with_cancer_in_Aquitania]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0242-6498(08)00295-2 DB - PRIME DP - Unbound Medicine ER -