Dataset for Reporting of Malignant Mesothelioma of the Pleura or Peritoneum: Recommendations From the International Collaboration on Cancer Reporting (ICCR)

Our plain-English summary of Dataset for Reporting of Malignant Mesothelioma of the Pleura or Peritoneum: Recommendations From the International Collaboration on Cancer Reporting (ICCR), by A. Churg, R. Attanoos, A.C. Borczuk, et al (Archives of Pathology & Laboratory Medicine, 2016).

The study

• Authors: A. Churg, R. Attanoos, A.C. Borczuk, L.R. Chirieac, F. Galateau-Sallé, A. Gibbs, D. Henderson, V. Roggli, V. Rusch, M.J. Judge, J.R. Srigley
• Journal: Archives of Pathology & Laboratory Medicine
• Published: 2016;140(10):1104-10
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Context: -The International Collaboration on Cancer Reporting is a not-for-profit organization formed by the Royal Colleges of Pathologists of Australasia and the United Kingdom; the College of American Pathologists; the Canadian Association of Pathologists-Association Canadienne des Pathologists, in association with the Canadian Partnership Against Cancer; and the European Society of Pathology. Its goal is to produce common, internationally agreed upon, evidence-based datasets for use throughout the world.

Objective: -To describe a dataset developed by the Expert Panel of the International Collaboration on Cancer Reporting for reporting malignant mesothelioma of both the pleura and peritoneum. The dataset is composed of "required" (mandatory) and "recommended" (nonmandatory) elements.

Design: -Based on a review of the most recent evidence and supported by explanatory commentary.

Results: -Eight required elements and 7 recommended elements were agreed upon by the Expert Panel to represent the essential information for reporting malignant mesothelioma of the pleura and peritoneum.

Conclusions: -In time, the widespread use of an internationally agreed upon, structured, pathology dataset for mesothelioma will lead not only to improved patient management but also provide valuable data for research and international benchmarks.

In plain English

This article is not a study of patients or of asbestos exposure. It describes a dataset, a standard list of items that an expert panel of the International Collaboration on Cancer Reporting (ICCR) agreed pathologists should include when reporting pleural or peritoneal malignant mesothelioma. The panel was made up of pathologists with mesothelioma expertise and one clinician. It compared existing reporting protocols, reviewed recent evidence, and posted a draft for two months of public comment. The scope was widened from pleural resection specimens to include peritoneal tumors and biopsies. Localized malignant mesothelioma was excluded. The article states that the panel agreed on 8 required items and 7 recommended items. The required items include tumor type, extent of invasion, lymph node status and TNM staging. However, the article's table of recommended items lists eight distinct items, counting its separate pleural and peritoneal tumor-size sections as one. The authors wrote that a history of asbestos exposure is not relevant for diagnosis because it does not change sample processing or diagnosis. They recommended noting coexisting findings such as asbestosis, asbestos bodies and pleural plaques. The authors concluded that widespread use of the dataset will improve patient management and provide research data.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Consensus reporting guideline (pathology dataset) developed by an expert panel from a review of evidence and existing datasets, with a period of public comment
• Who was studied: No patients were studied. The dataset was written by an ICCR Dataset Authoring Committee of pathologists with expertise in mesothelioma and one clinician. A draft was posted on the ICCR Web site for 2 months for public comment.
• Exposure: Not applicable: the article does not study an exposure. It sets out items for pathology reports on malignant mesothelioma of the pleura and peritoneum.
• Main results:
  • The article states that the Expert Panel agreed on 8 required (mandatory) elements and 7 recommended (nonmandatory) elements for reporting malignant mesothelioma of the pleura and peritoneum. However, Table 2, the table of recommended items, lists eight distinct items if its separate pleural and peritoneal tumor-size sections are counted as one: clinical history, neoadjuvant therapy, tumor size, block identification key, mitotic count, response to neoadjuvant therapy, coexistent pathology, and ancillary studies.
  • The required elements are the minimum information that should be included on the pathology report. They are: operative procedure, specimens submitted, macroscopic tumor site, histologic tumor type, margin status, extent of invasion, lymph node status, and pathologic staging (TNM, 7th edition).
  • The scope, first limited to pleural resection specimens, was expanded to include peritoneal as well as pleural lesions.
  • The scope was also expanded to include biopsy specimens.
  • Tumors are to be reported as epithelioid, sarcomatoid, or biphasic. By convention, a mesothelioma is called biphasic if the lesser component reaches 10% of the tumor examined.
  • The authors stated that a history of asbestos exposure is not relevant for diagnosing samples in which malignant mesothelioma is a consideration, because it does not influence sample processing or the final diagnosis.
  • Under the recommended element 'coexistent pathology', pathologists are asked to note nonneoplastic findings in extrapleural pneumonectomy specimens, including asbestosis, asbestos bodies and pleural plaques. Asbestosis should be diagnosed using the criteria of the asbestosis committee of the College of American Pathologists and the Pulmonary Pathology Society.
  • Localized malignant mesothelioma was judged sufficiently different from diffuse malignant mesothelioma that it was not included in the dataset.
• The authors' conclusion: The authors concluded that, in time, widespread use of an internationally agreed, structured pathology dataset for mesothelioma will lead to improved patient management and provide valuable data for research and international benchmarks.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Peritoneum, Pathology.

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