W B C Stevens1, J H van Krieken2, R D M Mus3, A I J Arens4, V Mattijssen5, M Oosterveld6, E J F M de Kruijf7, F de Vries8, A Koster9, R van der Maazen10, J Raemaekers11. 1. Departments of Hematology, RUN St Radboud, Nijmegen. Electronic address: w.stevens@hemat.umcn.nl. 2. Departments of Pathology, RUN St Radboud, Nijmegen. 3. Departments of Radiology, RUN St Radboud, Nijmegen. 4. Departments of Nuclear Medicine, RUN St Radboud, Nijmegen. 5. Department of Internal Medicine, Rijnstate Hospital, Arnhem. 6. Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen. 7. Department of Internal Medicine, Hospital de Gelderse Vallei, Ede. 8. Department of Internal Medicine, Slingeland Hospital, Doetinchem. 9. Department of Internal Medicine, VieCurie Medical Centre Noord-Limburg, Venlo. 10. Departments of Radiotherapy, RUN St Radboud, Nijmegen, The Netherlands. 11. Departments of Hematology, RUN St Radboud, Nijmegen, The Netherlands.
Abstract
BACKGROUND: Hodgkin Lymphoma (HL) is highly curable when treated accurately. The challenge is to cure patients with the minimal risk of long-term complications. For that, optimal initial diagnostics are required to determine the optimal treatment plan. We offer non-academic hospitals in our Regional Comprehensive Cancer Centre network a centralised review of all diagnostic procedures from patients with newly diagnosed HL. We report our experience on concordances and discrepancies between local findings and central review results. PATIENTS AND METHODS: A haematologist and radiation oncologist at the Hodgkin Radboud University Nijmegen Medical Centre outpatient clinic examined all patients with newly diagnosed HL between February 2006 and May 2010. In a multidisciplinary lymphoma conference, diagnostic information is reviewed and treatment advice formulated. Discordant findings in pathology, staging and therapy were recorded as 'minor', no therapeutic consequences or 'major', adapted therapy advice. RESULTS: Altogether, 125 patients were included. Pathology review showed 86% concordance, with 4% major discordance, mainly nodular lymphocyte predominant sub-type. Revision of initial staging was concordant in 77%; however 15% major discordance of which most were upstaged. This resulted in 19% treatment adaption. CONCLUSION: Our findings highlight the discrepancies in interpretation of diagnostic tests. We advocate centralised review process for all newly diagnosed patients with HL.
BACKGROUND:Hodgkin Lymphoma (HL) is highly curable when treated accurately. The challenge is to cure patients with the minimal risk of long-term complications. For that, optimal initial diagnostics are required to determine the optimal treatment plan. We offer non-academic hospitals in our Regional Comprehensive Cancer Centre network a centralised review of all diagnostic procedures from patients with newly diagnosed HL. We report our experience on concordances and discrepancies between local findings and central review results. PATIENTS AND METHODS: A haematologist and radiation oncologist at the Hodgkin Radboud University Nijmegen Medical Centre outpatient clinic examined all patients with newly diagnosed HL between February 2006 and May 2010. In a multidisciplinary lymphoma conference, diagnostic information is reviewed and treatment advice formulated. Discordant findings in pathology, staging and therapy were recorded as 'minor', no therapeutic consequences or 'major', adapted therapy advice. RESULTS: Altogether, 125 patients were included. Pathology review showed 86% concordance, with 4% major discordance, mainly nodular lymphocyte predominant sub-type. Revision of initial staging was concordant in 77%; however 15% major discordance of which most were upstaged. This resulted in 19% treatment adaption. CONCLUSION: Our findings highlight the discrepancies in interpretation of diagnostic tests. We advocate centralised review process for all newly diagnosed patients with HL.
Authors: L Strobbe; L L F G Valke; I J Diets; M van den Brand; K Aben; J M M Raemaekers; K M Hebeda; J H J M van Krieken Journal: Ann Hematol Date: 2016-01-05 Impact factor: 3.673