Missing data was common in pathology reports of vulvar carcinoma: a population based Ontario cohort

Purpose — We conducted a population based patterns of care study of vulvar carcinoma. This paper describes the completeness of pathology reporting for this cohort.

Methods — This is a retrospective population-based cohort study. We obtained all pathology records available from the provincial cancer registry for primary invasive squamous cell carcinoma of the vulva diagnosed between 1998 and 2007. Original pathology reports of vulva specimens pertaining to initial management were included. Abstracted variables included tumor size, grade, depth of invasion, thickness, margin status, lympho-vascular space invasion (LVSI), date, institution and pathologist type.

Results — 1011 vulvar resection reports were identified. Overall, 16% of reports were complete for all variables. Frequency of reporting each individual variable improved over time as did overall completeness. Peripheral margins were as reported most frequently (88%) and thickness was reported least frequently (43%). Gyne-pathologists reported each variable more frequently than general pathologists (48% complete for all variables vs. 22%). There was significant variation by institution. The largest improvement was observed in a single institution that implemented a checklist midway through the study period.

Conclusions — Pathology reports for vulva carcinoma are frequently missing information important for clinical decision making. Checklists or synoptic reporting are likely to improve the amount of missing information.