Improving Reporting of Tumor Size in Synoptic Reports
Andrew A. Renshaw, Edwin W. Gould · Archives of Pathology & Laboratory Medicine · 2020
CONTEXT.—: Tumor size is an important prognostic feature in many synoptic reports. The best format to report this feature is not clearly defined. OBJECTIVE.—: To define formatting features that impact the significance of tumor size. DESIGN.—: We reviewed multiple formatting features of tumor size in synoptic reports and correlated them with size distribution, reproducibility, and other pathologic features. RESULTS.—: Reporting tumors in millimeters rather than centimeters was more precise because of reduced rounding error and was significantly more reproducible (P = .01). Tumor sizes where the pathologist was concerned that the size may be underestimated are associated with significantly higher tumor N stage than tumors of similar size that are not so identified. Reported tumor sizes in multifocal tumors are also associated with significantly higher N stage than unifocal tumors of the same size. CONCLUSIONS.—: Tumor sizes should be reported in millimeters, and when tumors are reported as either "at least" a specific size or as "multifocal" this information should also be recorded because these sizes likely underestimate the true biologic potential of the tumor.