KEY TAKEAWAYS
- The study aimed to enhance documentation of intraoperative margin mapping and supplemental margin details in HNC.
- The results showed the redesigned pathology report improves margin documentation and helps in radiation planning.
Surgical pathology reports are crucial for managing patients with head and neck cancer (HNC) postoperatively. These reports must convey essential information for complex resections to all clinicians involved. Earlier, we showed that 3D scanning of specimens and defects effectively communicates margin status and documents supplemental margin locations.
Jun Yun and the team aimed to present a redesigned permanent pathology report that enhances the documentation of intraoperative margin mapping and the extent of supplemental margins harvested.
The study tested the hypothesis that gaps in understanding exist in head and neck resection pathology reports across providers. A cross-sectional exploratory study using human-centered design was conducted to assess the current permanent pathology report’s effectiveness in communicating margin status.
Pathologists, surgeons, radiation oncologists, and medical oncologists from U.S. medical institutions were surveyed. The findings supported redesigning the surgical pathology template to include 3D scans of specimens and defects, as well as annotated radiographic images showing inadequate margins needing supplemental treatment or positive margins found in permanent sections.
About 47 physicians completed the survey. Of those, 28 (60%) reported confusion about whether re-excised supplemental margins indicated clear margins, 20 (43%) were uncertain about the final margin status, and 20 (43%) needed more clarity on the extent of supplemental margins harvested intraoperatively.
Based on this feedback, a new pathology report template was designed, and 61 permanent pathology reports were compiled using this template over a 12-month period.
The study concluded that feedback from survey respondents led to a redesigned permanent pathology report. This report provides detailed visual anatomical information on intraoperative margin findings and the size and location of harvested supplemental margins.
It reconciles frozen and permanent section results and includes annotated radiographic images, enabling clinicians to understand the surgical actions taken for inadequate margins and identify areas of concern that may impact adjuvant radiation planning.
This study did not receive any funding. The authors report no conflicts of interest.
Source: https://pubmed.ncbi.nlm.nih.gov/39153096/
Yun J, Kapustin D, Joseph J, et al. (2024). “Improving Interdisciplinary Communication and Pathology Reporting for Head and Neck Cancer Resections: 3D Visualizations and Margin Reconciliation.” Head Neck Pathol. 2024;18(1):78. Published 2024 Aug 17. doi:10.1007/s12105-024-01684-9
