Modern Pathology (2015) 28, 1101–1122 © 2015 USCAP, Inc All rights reserved 0893-3952/15 $32.00 1101 Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR) W Glenn McCluggage1,15, Meagan J Judge2, Blaise A Clarke3, Ben Davidson4,5, C Blake Gilks6, Harry Hollema7, Jonathan A Ledermann8, Xavier Matias-Guiu9, Yoshiki Mikami10, Colin JR Stewart11,12, Russell Vang13 and Lynn Hirschowitz14,16 1Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK; 2Royal College of Pathologists of Australasia, Sydney, NSW, Australia; 3Department of Pathology and Laboratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada; 4Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway; 5Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 6Department of Pathology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada; 7Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 8Department of Oncology, UCL Cancer Institute, London, UK; 9Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain; 10Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan; 11Department of Histopathology, King Edward Memorial Hospital, Perth, WA, Australia; 12School for Women's and Infant's Health, University of Western Australia, Crawley, WA, Australia; 13Department of Pathology (Division of Gynecologic Pathology), The Johns Hopkins University School of Medicine, Baltimore, MD, USA and 14Department of Cellular Pathology, Birmingham Women’s Hospital, Birmingham, UK A comprehensive pathological report is essential for optimal patient management, cancer staging and prognostication. In many countries, proforma reports are used but these vary in their content. The International Collaboration on Cancer Reporting (ICCR) is an alliance formed by the Royal College of Pathologists of Australasia, the Royal College of Pathologists of the United Kingdom, the College of American Pathologists, the Canadian Partnership Against Cancer and the European Society of Pathology, with the aim of developing an evidence-based reporting data set for each cancer site. This will reduce the global burden of cancer data set development and reduplication of effort by different international institutions that commission, publish and maintain standardised cancer reporting data sets. The resultant standardisation of cancer reporting will benefit not only those countries directly involved in the collaboration but also others not in a position to develop their own data sets. We describe the development of a cancer data set by the ICCR expert panel for the reporting of primary ovarian, fallopian tube and peritoneal carcinoma and present the ‘required’ and ‘recommended’ elements to be included in the report with an explanatory commentary. This data set encompasses the recent International Federation of Obstetricians and Gynaecologists staging system for these neoplasms and the updated World Health Organisation Classification of Tumours of the Female Reproductive Organs. The data set also addresses issues about site assignment of the primary tumour in high-grade serous carcinomas and proposes a scoring system for the assessment of tumour response to neoadjuvant chemotherapy. The widespread implementation of this data set will facilitate consistent and accurate data collection, comparison of epidemiological and pathological parameters between different populations, facilitate research and hopefully will result in improved patient management. Modern Pathology (2015) 28, 1101–1122; doi:10.1038/modpathol.2015.77; published online 19 June 2015 Correspondence: Professor WG McCluggage, FRCPath, Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BA, Northern Ireland. E-mail: [email protected] 15Chair of the ICCR Ovarian/Fallopian tube and Primary Peritoneal Site Cancer Panel. 16The ICCR Steering Group Representative. Received 13 January 2015; revised 24 February 2015; accepted 25 February 2015; published online 19 June 2015 www.modernpathology.org Ovary, tube and primary peritoneal data set 1102 WG McCluggage et al The Colleges of American, Australasian and United of standardised data sets is to ensure that histo- Kingdom Pathologists and the Canadian Partnership pathology reports include all relevant information Against Cancer formed the International Collabora- (based on current knowledge) and present it in a tion on Cancer Reporting (ICCR) in 2011 to reduce consistent, concise format that conforms to interna- the global burden of cancer data set development tional standards. Although much of the content of and reduplication of effort by different international the independently developed cancer reporting pro- institutions that commission, publish and maintain tocols is similar, if cancer data are to be aggregated standardised cancer-reporting data sets. Many coun- across large populations, much closer harmonisation tries, including those involved in the ICCR, expend a of approach, uniformity of content and standardised great deal of time, effort and resources to commis- nomenclature to define the data items are needed; the sion, publish and maintain their own standardised data sets in different parts of the world should include cancer-reporting data sets. Other countries lack the same items of information, defined in the same sufficient pathologist manpower and other resources way and described using the same terms. Without this, to develop or implement standardised cancer- meaningful international comparison, benchmarking reporting protocols and will benefit from the avail- and epidemiological analysis are not possible. ability of internationally accredited data sets. The ICCR has developed and ratified a suite of The ICCR alliance has successfully developed four standard operating procedures for the process of data – data sets on prostatic, endometrial and lung cancers set development (described in earlier publications1 4) and malignant melanoma. All of the data sets are and also defined the selection process, roles and evidence-based, have been produced by a panel of responsibilities of the chair, expert panel members, internationally renowned expert pathologists and a the ICCR Steering Committee representative on the single clinician in a specific field, have been subject panel and the project manager. to international open consultation and are freely The scope of this data set was to cover resection available for worldwide use at the following website: specimens of primary borderline and malignant http://www.rcpa.edu.au/Library/Practising-Pathology/ epithelial tumours of the ovary, fallopian tube and ICCR/Cancer-Datasets. The process of production of peritoneum. After the expert panel was established, each of these data sets has been published in peer- the project manager collated existing international reviewed journals.1–4 data sets for these tumours and scheduled a series The ICCR is currently in the process of becoming of teleconferences to review and discuss each of incorporated that will facilitate financial support of the elements in the collated data set. As FIGO staging an expanded membership and allow the continued of ovarian, fallopian tube and primary peritoneal development of high-quality cancer data sets for carcinoma has now been revised and amalgamated international use. The founding members include into one unified staging system,5 the Chair of the the original quadripartite group together with the expert panel (WGM) took the decision to produce a European Society of Pathology. The ICCR has also single cancer data set for these tumours. formed strategic partnerships with the International The elements under discussion by the expert panel Agency for Research on Cancer (IARC) (the organisa- included REQUIRED elements, defined as those tion that is responsible for producing the World which are unanimously agreed by the panel to be Health Organisation (WHO) monographs, the ‘Blue essential for the histological diagnosis, clinical man- books’ on tumour classification), the organisations agement, staging or prognosis of ovarian, fallopian tube responsible for tumour staging—Union for Interna- and primary peritoneal cancer, and RECOMMENDED tional Cancer Control (UICC), American Joint Com- elements, defined as non-mandatory which are clini- mittee on Cancer (AJCC) and the International cally important and recommended as good practice Federation of Obstetricians and Gynaecologists and should ideally be included in the data set but (FIGO)—and other bodies such as European Organi- which are not yet validated or regularly used in patient sation for Research and Treatment of Cancer, which management. Evidentiary support at Level III-2 or develops, conducts, coordinates and promotes trans- above (based on prognostic factors in the NHMRC lational and clinical research in Europe to improve levels of evidence document and defined as ‘Analysis the management of cancer. These strategic partner- of prognostic factors amongst persons in a single arm of ships underpin the cancer data set development a randomised controlled trial’)6 is required to support process and facilitate the co-ordination of data set required (mandatory)