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Dataset for Histopathological Reporting of Primary Cutaneous Adnexal Carcinomas and Regional Lymph Nodes

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Standards and datasets for reporting cancers Dataset for histopathological reporting of primary cutaneous adnexal carcinomas and regional lymph nodes February 2019 Authors: Dr David Slater, Chesterfield Royal Hospital NHS Foundation Trust Dr Paul Barrett, County Durham and Darlington NHS Foundation Trust Unique document number G127 Document name Dataset for histopathological reporting of primary cutaneous adnexal carcinomas and regional lymph nodes Version number 3 Produced by Dr David Slater is a consultant dermatopathologist and member of the RCPath Specialist Advisory Committee (SAC), co-organiser of the National Specialist Dermatopathology EQA Scheme, member of the British Association of Dermatologists’ (BAD) Skin Cancer Clinical Guideline Development Groups, past President of the British Society of Dermatopathology, Chair of the RCPath SAC on Dermatopathology, Chair of RCPath Examiners for the Diploma in Dermatopathology, dermatopathologist member of the Skin Cancer Guidance Development Group for NICE and Deputy Editor of British Journal of Dermatology. Dr Paul Barrett is a consultant pathologist and co-opted member of the RCPath SAC, lead for joint RCPath–BAD National Non-melanoma Skin Cancer Audit, Chair of the North of England Cancer Alliance Skin Cancer Expert Reference Group, member of the RCPath Working Group on Cancer Services and representative for RCPath on the International Collaboration on Cancer Reporting Dataset Steering Committee. Date active February 2019 (to be implemented within three months) Date for full revision February 2022 Comments This document will replace the 2nd edition first published in 2014. This is to incorporate the TNM Classification of Malignant Tumours (8th edition) from the Union for International Cancer Control (UICC) published in 2017. In accordance with the College’s pre-publications policy, this document was on the College website for consultation from 6 September to 4 October 2018. Responses and authors’ comments are available to view on request. Dr Brian Rous Clinical Lead for Guideline Review (Cellular Pathology) 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 © 2019, The Royal College of Pathologists This work is copyright. You may download, display, print and reproduce this document for your personal, non- commercial use. All other rightd reserved. Requests and inquiries concerning reproduction and rights should be addressed to the Royal College of Pathologists. First published: 2019. CEff 070219 1 V3 Final Contents Foreword .............................................................................................................................................. 3 1 Introduction ................................................................................................................................. 4 2 Clinical information required on the specimen request form ..................................................... 8 3 Preparation of specimens before dissection .............................................................................. 8 4 Specimen handling, dissection and block selection .................................................................. 9 5 Core data items ........................................................................................................................ 11 6 Non-core data items ................................................................................................................. 19 7 Diagnostic staging and coding.................................................................................................. 21 8 Small biopsy specimens ........................................................................................................... 23 9 Reporting of frozen sections..................................................................................................... 23 10 Cytological diagnosis ................................................................................................................ 23 11 Specific aspects of individual tumours not covered elsewhere ............................................... 23 12 Criteria for audit ........................................................................................................................ 24 13 Acknowledgements .................................................................................................................. 24 14 References ............................................................................................................................... 25 Appendix A UICC TNM 8 pathological staging of primary cutaneous carcinoma .................... 27 Appendix B Cutaneous adnexal carcinoma SNOMED coding ................................................. 30 Appendix C (Draft) UK National Histopathology Request Form for skin biopsies ................... 32 Appendix D1 Reporting proforma for cutaneous adnexal carcinoma removed with therapeutic intent ................................................................................................... 33 Appendix D2 Reporting proforma for regional lymph nodes associated with cutaneous adnexal carcinoma................................................................................................. 35 Appendix E1 Reporting proforma for cutaneous adnexal carcinoma removed with therapeutic intent in list format .............................................................................. 38 Appendix E2 Reporting proforma for regional lymph nodes associated with cutaneous adnexal carcinoma in list format............................................................................ 43 Appendix F Summary table – Explanation of levels of evidence ............................................. 48 Appendix G AGREE II compliance monitoring sheet ................................................................ 49 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 CEff 070219 2 V3 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 D1, D2, E1 and E2) that are mandated for inclusion in the Cancer Outcomes and Services Dataset (COSD – previously the National Cancer Dataset) 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 organisations were consulted during its preparation and approved the dataset: • British Association of Dermatologists (BAD; member of the RCPath Specialty Advisory Committee on Dermatopathology) • British Society for Dermatopathology (BSD; member of the RCPath Advisory Committee on Dermatopathology) • participating members of the National Specialist Dermatopathology External Quality Assessment (NSDEQA) scheme (member of the RCPath Speciality Advisory Committee on Dermatopathology). This dataset has been constructed taking into account the strong evidence that is contained in, and forms the basis for, the following national and international publications. All publications have widespread national and/or international peer acceptance and reflect the current accepted professional standards and practice in skin cancer: • Union for International Cancer Control (UICC)1 • American Joint Committee on Cancer (AJCC)2 • World Health Organization (WHO) Classification of Skin Tumours3 • National Institute for Health and Clinical Excellence (NICE) Guidance and Quality Standards on skin cancer and melanoma4,5 • NHS Evidence6 • Public Health England (PHE) COSD.7 This relates to the core data items for all skin cancers – a specific dataset for adnexal carcinoma is not yet available. PHE, however, intends to eventually include rare skin cancers in COSD as indicated in the 2011 National Cancer Intelligence Network (NCIN) Data Briefing. • NHS England Quality Surveillance Programme (QSP; formerly the National Cancer Peer Review Programme)8 • Armed Forces Institute of Pathology (AFIP) Atlas of Tumour Pathology (noting AFIP disestablished
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