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Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group.
- Source :
- British Journal of Haematology; Nov2015, Vol. 171 Issue 4, p547-556, 10p, 2 Diagrams, 3 Charts
- Publication Year :
- 2015
-
Abstract
- Accurate clinical staging is crucial for adequate risk-adapted treatment in Hodgkin lymphoma ( HL) to prevent patients from under- or over-treatment. Within the latest German Hodgkin Study Group trial generation, diagnostic findings such as histopathology, computerized tomography imaging and clinical risk factors were re-evaluated by expert panels. Here, we retrospectively analysed 5965 patients and identified 399 in who major discordant findings changed their first-line treatment allocation. Histopathology review did not confirm the initial diagnosis of HL in 87 patients. Treatment allocation was revised in 312 of the remaining 5878 patients: 176 were assigned to a higher and 128 to a lower risk group, respectively; the correct treatment group remained unclear in 8 patients. Cases of revised treatment allocation accounted for 9·8%, 6·0%, 0·8%, and 14·8% of patients initially assigned to the HD13, HD14, HD15 trials and stage IA lymphocyte-predominant HL project, respectively. Most revisions were due to wrong application of clinical stage (20·5% of 312 patients with revised treatment group), histological subtype (9·0%) or the risk factors ≥3 involved areas (46·8%) or large mediastinal mass (9·3%). In conclusion, centralized review by experienced experts changed risk-adapted first-line treatment in a relevant proportion of HL patients. Quality control measures clearly improve the accuracy of treatment and should be implemented in clinical practice. [ABSTRACT FROM AUTHOR]
- Subjects :
- HODGKIN'S disease
DIAGNOSIS
LYMPHOMAS
CLINICAL medicine
QUALITY control
Subjects
Details
- Language :
- English
- ISSN :
- 00071048
- Volume :
- 171
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- British Journal of Haematology
- Publication Type :
- Academic Journal
- Accession number :
- 110605014
- Full Text :
- https://doi.org/10.1111/bjh.13646