Background:
The New Zealand Melanoma Guidelines Group and the American Joint Committee on Cancer (AJCC) advocate specific elements of structured histopathological reporting of primary cutaneous melanomas as essential, due to their critical role in determining patient prognosis and management. We examined compliance with three key essential histopathological reporting elements at our regional skin cancer treatment centre over 5 years.
Methods:
A restrospective chart review was performed on all primary cutaneous melanomas reported at CMDHB over 5 years between 2010 to2014 inclusive. Reporting of Breslow thickness, ulceration and mitotic rate was analysed using logistic regression to estimate the effect of several variables on compliance.
Results:
346 unique histopathology reports were evaluated. 305/346 (88.2%) of reports recorded all three essential parameters. Breslow thickness was reported in 327/346 (94.5%), ulceration in 318/346 (91.9%) and mitotic rate in 316/346 (91.3%). Incomplete reporting was strongly associated with incisional biopsy (p value = 0.0001). In contrast, year of reporting was associated with increased compliance, with an 11% improvement between 2010-2014 (p value = 0.01).
Conclusions:
Compliance with essential elements of histopathological reporting for primary cutaneous melanoma has increased over time, but remains incomplete. Breslow thickness is most consistently reported, while ulceration and mitotic rate are less regularly reported. Compliance is likely to improve with greater understanding of clinical implications of essential histopathological parameters and routine adoption of standardised synoptic reporting. Prospective studies evaluating this are underway in our Unit.