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G046 Dataset for the Histopathological Reporting of Testicular Neoplasms

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G046 Dataset for the Histopathological Reporting of Testicular Neoplasms Standards and datasets for reporting cancers Dataset for histopathological reporting of testicular neoplasms May 2020 Authors: Professor Dan Berney, Barts Health NHS Trust, London Professor Clare Verrill, Oxford University Hospitals NHS Trust, Oxford Unique document number G046 Document name Dataset for histopathological reporting of testicular neoplasms Version number 4 Produced by Professor Dan Berney (St Bartholomew’s Hospital, Queen Mary University of London, Barts Health NHS Trust) and Professor Clare Verrill (John Radcliffe Hospital, Oxford University Hospitals NHS Trust) are supraregional pathology leads for testicular neoplasms. Professor Berney and Professor Verrill have published numerous papers and guidance, and Professor Berney has published chapters on testicular neoplasia. Date active May 2020 (to be implemented within three months) Date for full revision May 2023 Comments This document replaces the 3rd edition of Dataset for the histological reporting of testicular neoplasms, published in 2014. In accordance with the College’s pre-publications policy, this document was on the Royal College of Pathologists’ website for consultation from 25 March to 22 April 2020. Responses and authors’ comments are available to view on publication of the final document. Dr Brian Rous Clinical Lead for Guideline Review The Royal College of Pathologists 6 Alie Street, London E1 8QT Tel: 020 7451 6700 Fax: 020 7451 6701 Web: www.rcpath.org Registered charity in England and Wales, no. 261035 © 2020, The Royal College of Pathologists This work is copyright. You may download, display, print and reproduce this document for your personal, non-commercial use. Apart from any use as permitted under the Copyright Act 1968 or as set out above, all other rights are reserved. Requests and inquiries concerning reproduction and rights should be addressed to the Royal College of Pathologists at the above address. First published: 2020. CEff 130520 1 V4 Final Contents Foreword ........................................................................................................................................ 3 1 Introduction .............................................................................................................................. 4 2 Clinical information required on the specimen request form ..................................................... 6 3 Preparation of specimens before dissection ............................................................................. 6 4 Specimen handling and block selection ................................................................................... 7 5 Core data items ..................................................................................................................... 12 6 Non-core data items............................................................................................................... 21 7 Diagnostic coding and staging ............................................................................................... 21 8 Reporting of biopsy specimens .............................................................................................. 22 9 Reporting of frozen sections .................................................................................................. 22 10 Use of immunohistochemistry/molecular tests ....................................................................... 22 11 Criteria for audit ..................................................................................................................... 23 12 References ............................................................................................................................ 24 Appendix A TNM pathological staging (UICC TNM 8) ................................................................. 31 Appendix B SNOMED coding of testicular tumours ..................................................................... 34 Appendix C Reporting proforma for testicular cancer (orchidectomy) .......................................... 36 Appendix D Reporting proforma for testicular cancer (retroperitoneal lymph node dissections, other lymph node excisions or resections of metastatic deposits) ............................ 38 Appendix E Reporting proforma for testicular cancer (orchidectomy) in list format ...................... 40 Appendix F Reporting proforma for testicular cancer (retroperitoneal lymph node dissections, other lymph node excisions or resections of metastatic) in list format ...................... 44 Appendix G Summary table – explanation of levels of evidence .................................................. 46 Appendix H AGREE II compliance monitoring sheet ................................................................... 47 NICE has accredited the process used by the Royal College of Pathologists to produce its cancer datasets. Accreditation is valid for five years from 25 July 2017. More information on accreditation can be viewed at www.nice.org.uk/accreditation. For full details on our accreditation visit: www.nice.org.uk/accreditation. CEff 130520 2 V4 Final Foreword The cancer datasets published by the Royal College of Pathologists (RCPath) are a combination of textual guidance, educational information and reporting proformas. The datasets enable pathologists to grade and stage cancers in an accurate, consistent manner in compliance with international standards and provide prognostic information, thereby allowing clinicians to provide a high standard of care for patients and appropriate management for specific clinical circumstances. This guideline has been developed to cover most common circumstances. However, we recognise that guidelines cannot anticipate every pathological specimen type and clinical scenario. Occasional variation from the practice recommended in this guideline may therefore be required to report a specimen in a way that maximises benefit to the patient. Each dataset contains core data items (see Appendices C–F) that are mandated for inclusion in the Cancer Outcomes and Services Dataset (COSD – previously the National Cancer Data Set) in England. Core data items are items that are supported by robust published evidence and are required for cancer staging, optimal patient management and prognosis. Core data items meet the requirements of professional standards (as defined by the Information Standards Board for Health and Social Care [ISB]) and it is recommended that at least 95% of reports on cancer resections should record a full set of core data items. Other non-core data items are described. These may be included to provide a comprehensive report or to meet local clinical or research requirements. All data items should be clearly defined to allow the unambiguous recording of data. The following stakeholders were contacted to consult on this document: British Association of Urological Surgeons (BAUS)/BAUS Section of Oncology National Cancer Research Institute Teenage and Young Adults (NCRI TYA)/Testis Cancer Clinical Studies Group British Association of Urological Pathologists (BAUP) UK Association of Cancer Registries (UKACR). Advice has also been sought from: International Society of Urological Pathology (ISUP) European Network of Uropathology (ENUP). Evidence review Evidence was sought by review of the previous dataset, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) and PubMed searches reviewing recent articles on risk factors associated with testicular cancer. Recent review articles on testicular cancer were also reviewed. Strength of the data was evaluated according to the modified SIGN guidance (see Appendix G). The sections of this dataset that indicate compliance with each of the AGREE II standards are indicated in Appendix H. Supporting evidence and recommendations in this dataset are also based on: PubMed literature searches (up to January 2019) WHO Classification of Tumours of the Urinary System and Male Genital Organs, 20161 International Society of Urological Pathology (ISUP) consensus conference 2015 recommendations2,3 Datasets for the reporting of neoplasia of the testis: recommendations from the International Collaboration on Cancer Reporting4 National Institute for Health and Clinical Excellence (NICE) Improving outcomes in urological cancer, 20025 CEff 130520 3 V4 Final TNM staging classifications (8th edition).6,7 Most of the supporting evidence is level C or D at least, or meets the Good Practice Point (GPP) criteria. Evidence is often poor for these relatively rare tumours, usually limited to large cohort studies at best. Disagreements between the authors were settled by discussion, and when no agreement was possible this has been discussed in the text. No major conflicts in the evidence have been identified and any minor discrepancies between evidence have been resolved by expert consensus. No major organisational changes have been identified that would hinder the implementation of the dataset and there are no new major financial or work implications arising from the implementation, compared with the previous dataset. A formal revision cycle for all cancer datasets takes place on a three-yearly basis. However, each year, the College will ask the authors of the dataset, in conjunction with the relevant subspecialty adviser to the College, to consider whether or not the dataset needs to be revised. A full consultation process will be undertaken if major revisions are required, i.e. revisions to core data items (the only exception being changes to international tumour
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