4 Documentation of the microscopic features is important not only for clinical governance but also to indicate the process of diagnostic decision-making and describe any areas of uncertainty. 3 For this reason, pathology reports of melanocytic lesions should: (1) document the key diagnostic criteria on which the diagnosis was based and (2) provide histologic and other parameters important for patient prognosis and treatment. Of even greater importance is the need to accurately determine whether a cutaneous melanocytic lesion is benign or malignant (ie, nevus or melanoma). Accordingly, accurate assessment and documentation of important pathologic variables are essential. ![]() Histologic parameters of the primary tumor are the strongest predictors of outcome in patients with clinically localized primary melanoma and strongly influence the next stages of management. Pathologic assessment of a tissue biopsy is a critical aspect in the multidisciplinary management of melanoma patients. 1 Nevertheless, accurate diagnosis and appropriate treatment at an early clinical stage are associated with high cure rates. Because melanoma is one of the commonest cancers in young adults, it has a disproportionate effect on those in the most productive years of life. 1 Furthermore, in many Western countries, both incidence and mortality rates are increasing. Melanoma is the third most common cancer in both men and women in Australia, the fifth in both men and women in the United States, and the 12th in men and sixth in women in the United Kingdom. Melanoma is a major public health problem in many countries, particularly those with a large population of fair-skinned individuals. Widespread utilization of an internationally agreed upon, structured pathology data set for melanoma will lead not only to improved patient management but is a prerequisite for research and for international benchmarking in health care. Development and agreement of this evidence-based protocol at an international level was accomplished in a timely and efficient manner, and the processes described herein may facilitate the development of protocols for other tumor types. Consensus response values (permitted responses) were formulated for each data item. Eighteen additional data elements with a lesser level of evidentiary support were included in the recommended data set. Sixteen core/required data elements for cutaneous melanoma pathology reports were defined (with an additional 4 core/required elements for specimens received with lymph nodes). Recommended elements were those considered to be clinically important and recommended for good practice but with lesser degrees of supportive evidence. Required elements were defined as those that had agreed evidentiary support at National Health and Medical Research Council level III-2 level of evidence or above and that were unanimously agreed upon by the review panel to be essential for the clinical management, staging, or assessment of the prognosis of melanoma or fundamental for pathologic diagnosis. The International Collaboration on Cancer Reporting cutaneous melanoma expert review panel analyzed the existing RCPA, RCPath, and CAP data sets to develop a protocol containing “required” (mandatory/core) and “recommended” (nonmandatory/noncore) elements. In this study, data sets, checklists, and structured reporting protocols for pathologic examination and reporting of cutaneous melanoma were analyzed by an international panel of melanoma pathologists and clinicians with the aim of developing a common, internationally agreed upon, evidence-based data set. Protocols for the pathologic reporting of melanoma have been independently developed by the Royal College of Pathologists of Australasia (RCPA), Royal College of Pathologists (United Kingdom) (RCPath), and College of American Pathologists (CAP). An accurate and complete pathology report is critical for the optimal management of cutaneous melanoma patients.
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