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Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma

The diagnosis of cutaneous melanoma and melanocytic neoplasms in general is one of the most challenging fields in pathology, and the reported interobserver diagnostic agreement in the evaluation of melanocytic lesions is poor. Nevertheless, a correct histopathological diagnosis is crucial to ensure...

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Autores principales: Ronchi, Andrea, Pagliuca, Francesca, Zito Marino, Federica, Argenziano, Giuseppe, Brancaccio, Gabriella, Alfano, Roberto, Signoriello, Giuseppe, Moscarella, Elvira, Franco, Renato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890120/
https://www.ncbi.nlm.nih.gov/pubmed/33614670
http://dx.doi.org/10.3389/fmed.2020.568946
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author Ronchi, Andrea
Pagliuca, Francesca
Zito Marino, Federica
Argenziano, Giuseppe
Brancaccio, Gabriella
Alfano, Roberto
Signoriello, Giuseppe
Moscarella, Elvira
Franco, Renato
author_facet Ronchi, Andrea
Pagliuca, Francesca
Zito Marino, Federica
Argenziano, Giuseppe
Brancaccio, Gabriella
Alfano, Roberto
Signoriello, Giuseppe
Moscarella, Elvira
Franco, Renato
author_sort Ronchi, Andrea
collection PubMed
description The diagnosis of cutaneous melanoma and melanocytic neoplasms in general is one of the most challenging fields in pathology, and the reported interobserver diagnostic agreement in the evaluation of melanocytic lesions is poor. Nevertheless, a correct histopathological diagnosis is crucial to ensure a good clinical management of the patients. The institution of multidisciplinary teams has recently modified the approach to the patients with cutaneous melanoma. Patients referred to a multidisciplinary melanoma unit after receiving a diagnosis of melanoma elsewhere are encouraged to have their histopathological diagnosis confirmed by a second opinion from the experienced pathologist of the team before any treatment is initiated. We performed a retrospective analysis on a series of 121 histopathological revisions required for melanocytic neoplasms in the context of a multidisciplinary team, in order to evaluate the effects of second diagnostic opinion (SDO) on the clinical management of the patients. We defined three types of diagnostic discrepancies between the first diagnosis and the second opinion, according to the greatness of their clinical impact. Overall, the incidence of diagnostic discrepancies of any type was quite high in our series (56%). Interestingly, the SDO determined relevant changes in the clinical management of the patients in 33 out of 121 (27.3%) cases. This study confirms that SDO by expert pathologists significantly affects the course of treatment of melanoma patients and helps improving the diagnostic accuracy and clinical outcome.
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spelling pubmed-78901202021-02-19 Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma Ronchi, Andrea Pagliuca, Francesca Zito Marino, Federica Argenziano, Giuseppe Brancaccio, Gabriella Alfano, Roberto Signoriello, Giuseppe Moscarella, Elvira Franco, Renato Front Med (Lausanne) Medicine The diagnosis of cutaneous melanoma and melanocytic neoplasms in general is one of the most challenging fields in pathology, and the reported interobserver diagnostic agreement in the evaluation of melanocytic lesions is poor. Nevertheless, a correct histopathological diagnosis is crucial to ensure a good clinical management of the patients. The institution of multidisciplinary teams has recently modified the approach to the patients with cutaneous melanoma. Patients referred to a multidisciplinary melanoma unit after receiving a diagnosis of melanoma elsewhere are encouraged to have their histopathological diagnosis confirmed by a second opinion from the experienced pathologist of the team before any treatment is initiated. We performed a retrospective analysis on a series of 121 histopathological revisions required for melanocytic neoplasms in the context of a multidisciplinary team, in order to evaluate the effects of second diagnostic opinion (SDO) on the clinical management of the patients. We defined three types of diagnostic discrepancies between the first diagnosis and the second opinion, according to the greatness of their clinical impact. Overall, the incidence of diagnostic discrepancies of any type was quite high in our series (56%). Interestingly, the SDO determined relevant changes in the clinical management of the patients in 33 out of 121 (27.3%) cases. This study confirms that SDO by expert pathologists significantly affects the course of treatment of melanoma patients and helps improving the diagnostic accuracy and clinical outcome. Frontiers Media S.A. 2021-02-04 /pmc/articles/PMC7890120/ /pubmed/33614670 http://dx.doi.org/10.3389/fmed.2020.568946 Text en Copyright © 2021 Ronchi, Pagliuca, Zito Marino, Argenziano, Brancaccio, Alfano, Signoriello, Moscarella and Franco. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Ronchi, Andrea
Pagliuca, Francesca
Zito Marino, Federica
Argenziano, Giuseppe
Brancaccio, Gabriella
Alfano, Roberto
Signoriello, Giuseppe
Moscarella, Elvira
Franco, Renato
Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma
title Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma
title_full Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma
title_fullStr Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma
title_full_unstemmed Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma
title_short Second Diagnostic Opinion by Experienced Dermatopathologists in the Setting of a Referral Regional Melanoma Unit Significantly Improves the Clinical Management of Patients With Cutaneous Melanoma
title_sort second diagnostic opinion by experienced dermatopathologists in the setting of a referral regional melanoma unit significantly improves the clinical management of patients with cutaneous melanoma
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890120/
https://www.ncbi.nlm.nih.gov/pubmed/33614670
http://dx.doi.org/10.3389/fmed.2020.568946
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