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Results of histopathological revisions of major salivary gland neoplasms in routine clinical practice
  1. Sam T H Reerds1,
  2. Maike J M Uijen2,
  3. Adriana C H Van Engen-Van Grunsven3,
  4. Henri A M Marres1,
  5. Carla M L van Herpen2,
  6. Jimmie Honings1
  1. 1Department of Otorhinolaryngology and Head and Neck Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
  2. 2Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
  3. 3Department of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
  1. Correspondence to Sam T H Reerds, Department of Otorhinolaryngology and Head and Neck Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Gelderland, Netherlands; Sam.Reerds{at}radboudumc.nl

Abstract

Aims Salivary gland neoplasms are rare and are characterised by overlapping histopathological aspects. Therefore, the assessment of the correct histopathological diagnosis can be challenging. This study evaluated the frequency of pathology consultations and revisions for salivary gland neoplasms during routine clinical practice in the Netherlands. Furthermore, the concordance and discordance rates of these revisions are presented.

Methods The Dutch Pathology Registry (PALGA) was searched for patients that underwent a resection of a major salivary gland neoplasm between 2006 and 2016. Frequencies of pathology consultations and revisions are presented and, in order to calculate the rates of concordance and discordance, the results of the initial histopathological review were compared with the results of the revision.

Results Between 2006 and 2016, 13 441 major salivary gland neoplasms were resected in the Netherlands. 90% (n=12 082) of these tumours were diagnosed as benign and 10% (n=1359) as malignant. The initial pathologist requested a consultation in 3.3% of resections (n=439). Revision of the histopathological specimen was performed in 2.6% (n=350) of cases. Revisions were discordant in 8.3%; including 5.8% of the initially benign diagnosed lesions reclassified as malignant by the second expert pathologist and 8% of the revised malignant tumours that underwent a subtype change.

Conclusions The number of discordant histopathological revisions (8.3%) emphasises the complexity of the histopathological diagnosis of salivary gland neoplasms. An increase in consultations may improve the accuracy of the initial diagnosis and thus treatment in salivary gland tumours while lowering the need for revisions and the number of discordant revisions.

  • head and neck neoplasms
  • salivary glands
  • pathology
  • oral

Data availability statement

Data may be obtained from a third party and are not publicly available. Data were obtained from the PALGA database.

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Data availability statement

Data may be obtained from a third party and are not publicly available. Data were obtained from the PALGA database.

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Footnotes

  • STHR and MJMU are joint first authors.

  • Handling editor Runjan Chetty.

  • STHR and MJMU contributed equally.

  • Contributors Study concepts: STHR, MJMU, ACHVE-VG, JH, CMLvH, HAMM. Study design: STHR, MJMU, ACHVE-VG, JH. Data acquisition: STHR, MJMU. Quality control of data and algorithms: SHR. Data analysis and interpretation: STHR, MJMU. Statistical analysis: STHR, MJMU. Manuscript preparation: STHR, MJMU. Manuscript editing: STHR, MJMU, ACHVE-VG, JH, CMLvH, HAMM. Manuscript review: STHR, MJMU, ACHVE-VG, JH, CMLvH, HAMM. Guarantor: STHR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.