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5.9 QI 9 - Minimum required elements in pathology reports
5.9.1 Description of the QI
TYPE Process indicator.
DESCRIPTION Pathology report contains all the required elements listed in the international
collaboration on cancer reporting ICCR histopathology reporting guide 1) 2) .
SPECIFICATIONS Numerator: number of patients with advanced ovarian cancer undergoing cytoreductive
surgery who have a complete pathology report that contains all required elements as
defined in ICCR histopathology reporting guide.
Denominator: all patients with advanced ovarian cancer undergoing cytoreductive
surgery.
TARGETS ≥90%. The tolerance within this target reflects situations where it is not possible to
report all components of the data set due to poor quality of specimen.
SCORING RULE 3 if the target is met.
1) https://www.rcpa.edu.au/Library/Practising-Pathology/ICCR/Cancer-Datasets.
2) McCluggage, W.G., et al. Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the international
collaboration on cancer reporting ICCR. Mod Pathol 2015).
5.9.2 Rationale
An accurate pathology report is critical for the optimal management of advanced ovarian cancer patients. The
link between the absence of standardized reporting guide and deficiencies among reports is described for other
tumour types273-275. The report is essential for communication to treating physicians, data collection within
clinical trials, review by a second pathologist or when unforeseen problems arise and a reassessment is needed
later on. The distinction between primary ovarian and metastatic tumours is based on the interpretation of a
complex combination of macroscopic, microscopic and biochemical data and requires pathological expertise.
Histological reports must provide prognostic indicators which inform treatment planning for women diagnosed
with epithelial ovarian cancer. Three previous initiatives26,46,53 published a QI for this topic.
In 2015, an international panel of pathologists and clinicians developed a common, internationally agreed upon,
evidence-based ovarian cancer data set276. It contains “required” mandatory/core and “recommended” non -
mandatory/noncore elements. Required elements were defined as those that had agr eed evidentiary support and
that were unanimously agreed upon by the review panel to be essential for clinical management. Recommended
elements were those considered to be clinically important and recommended for good practice but with lesser
degrees of supportive evidence. The data set has been developed for resection specimens of primary borderline
and malignant epithelial tumours of the ovary, fallopian tubes and peritoneum. It does not include non-epithelial
ovarian neoplasms such as germ cell or sex cord stromal tumours or other primary peritoneal neoplasms such as
mesothelioma.
The international development group considers that a widespread utilization of this internationally agreed upon,
evidence-based, structured pathology data set for advanced ovarian cancer will lead not only to improved
patients management but is a prerequisite for research and for international benchmarking in health care.
5.9.3 Summary of available scientific evidence LoE 2-
Only one study116 was identified. As part of an audit, Vernooij et al.116 assessed the quality of 479
surgical pathology reports of advanced stage ovarian, fallopian tube and primary peritoneal cancer
from 40 institutions in 11 different countries. In absence of standardized pathology reports used in
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