Adherence to College of American Pathologists guidelines in laryngectomy specimen reporting: a quality improvement study

Background Cancer of the larynx shows high morbidity with poor survival rates. Prognostic outcomes and management plans depend on pathological reporting. Among the various components of the pathology report, the pathological stage plays a central role in guiding the management of these anatomically and histologically complex surgical specimens. Aim To assess the completeness of pathology reports of laryngeal carcinoma compared to the College of American Pathologists guidelines for laryngectomy specimen reporting through periodic service review. Materials and methods This study was a two-cycle audit evaluating the compliance of laryngeal cancer pathology reports with core data items set by the College of American Pathologists. In the first cycle (group A), 41 reports issued before any intervention were reviewed to establish a baseline of compliance with completeness of reports. An educational session was then conducted to address gaps identified in the first cycle, focusing on improving compliance with standardized reporting practices. In the second cycle (group B), 63 reports issued after the intervention were assessed to measure the impact of the educational session. Statistical methods for data analysis were implemented in reference to the assessment of consistency and improvement rates in groups A and B in pathology reporting for the cancer of the larynx. Results Group A of cancer larynx reports assessed showed that detailed site of transglottic extension, whether present or absent, was not documented in 18/41(43.9%), with improvement up to 79.4% reporting rate in group B after the targeted educational session. On the other hand, evaluation of other pathological parameters revealed that the least recorded item was the preepiglottic and/or paraglottic space, followed by commenting on thyroid gland status being reported in only 3/41 (7.3%) and 22/41 (53.7%), respectively, of the cases. Improvement in group B reporting regarding these items was observed in up to 71.4 and 76.2%, respectively. Reporting of nodal status (N) and presence or absence of extranodal extension has also improved from 88.2 and 63.6% of groups A and B up to 100 and 66.7%, respectively. Conclusion Following educational sessions directly addressing gaps identified in the first audit cycle, we observed significant improvements in the quality of structured pathology reports for laryngeal carcinoma, such as the assessment of preepiglottic and paraglottic space and thyroid gland status, which improved by 64.1 and 22.5%, respectively. The comment on transglottic extension presence or absence has also improved by 23.3%. We recommend periodic audits and continuous educational initiatives to address any remaining gaps, ensuring ongoing improvements in pathology report quality.