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The Desmoid Tumor Research Foundation

April 2018

The cost-saving effect of centralized histological reviews with soft tissue and visceral sarcomas, GIST, and desmoid tumors: The experiences of the pathologists of the French Sarcoma Group

Author Information

Perrier L(1)(2), Rascle P(2), Morelle M(1)(2), Toulmonde M(3), Ranchere Vince D(4), Le Cesne A(5), Terrier P(6), Neuville A(7), Meeus P(8), Farsi F(9), Ducimetiere F(10), Blay JY(11), Ray Coquard I(10)(11), Coindre JM(7)(12).

(1)University of Lyon, LŽon BŽrard Cancer Centre, GATE L-SE UMR 5824, Lyon, France. (2)Direction of Clinical Research and Innovation, DRCI, LŽon BŽrard Cancer Centre, Lyon, France. (3)Department of Medicine, Institut BergoniŽ, Bordeaux, France. (4)Department of Anatomopathology, Cancer Centre LŽon BŽrard, Lyon, France. (5)Department of Medicine, Institut Gustave Roussy, Villejuif, France. (6)Department of Pathology, Gustave Roussy, Villejuif, France. (7)Department of Anatomopathology, Institut BergoniŽ, Bordeaux, France. (8)Department of Surgery, Cancer Centre LŽon BŽrard, Lyon, France. (9)RŽseau Espace SantŽ Cancer Rh™ne-Alpes, Lyon, France. (10)SantŽ-Individu-sociŽtŽ EA-INSERM 4129, Cancer centre LŽon BŽrard, Lyon,France. (11)Department of Medicine, Cancer Centre LŽon BŽrard, Lyon, France. (12)University Victor SŽgalen, Bordeaux, France.

Publication

PLoS One

Summary

This study examined the types of discordance occurring in the diagnosis of soft tissue and visceral sarcomas, gastrointestinal stromal tumors (GIST), and desmoid tumors, as well as the economic impact of diagnostic discrepancies. We carried out a retrospective, multicenter analysis using prospectively implemented databases performed on a cohort of patients within the French RRePS network in 2010. Diagnoses were deemed to be discordant based on the 2013 World Health Organization (WHO) classification. A total of 2,425 patients were included. Three hundred forty-one patients (14%) had received discordant diagnoses. These discordances were determined to mainly be benign tumors diagnosed as sarcomas (n = 124), or non-sarcoma malignant tumors diagnosed as sarcomas (n = 77). The probability of discordance was higher for a final diagnosis of desmoid tumors when compared to liposarcomas (odds ratio = 5.1; 95%CI [2.6-10.4]). Our findings highlight misdiagnoses of sarcomas, which were found to most often be confused with benign tumors. Centralized histological reviews are likely to provide cost-savings for the French NHI.

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