Department of Pathology, The University of Chicago Medicine, Chicago, IL, USA.
Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Int J Surg Pathol. 2024 Apr;32(2):273-278. doi: 10.1177/10668969231177408. Epub 2023 May 24.
Increasing survivorship in kidney cancer patients has shifted treatment strategies to optimize renal function preservation. In 2010, the College of American Pathologists (CAP) updated their synoptic reporting guidelines for tumor nephrectomies to require evaluation of the nonneoplastic kidney parenchyma. We conducted this study to understand current practice behaviors regarding the evaluation of the nonneoplastic kidney parenchyma in tumor nephrectomy specimens. We emailed a 14-item multiple-choice survey to members of the Renal Pathology Society and Genitourinary Pathology Society. We also emailed a 12-item survey to program and associate program directors of American pathology residencies to assess the current state of renal pathology education. Ninety-eight genitourinary and 104 renal pathologists responded to the survey on the nonneoplastic kidney parenchyma. Ninety-five percent of respondents who examine tumor nephrectomies reported evaluating the nonneoplastic kidney parenchyma. Seventy-five percent of genitourinary pathologists and 67% of renal pathologists use synoptic reporting, and 81% use the CAP protocol. Thirty-nine percent of respondents report always contacting the clinician when they find evidence of medical renal disease. Forty-two program leaders responded to our renal pathology education survey, and 64% of them have a mandatory renal pathology rotation that on average lasts about 2 to 4 weeks. The majority of pathologists examine the nonneoplastic kidney parenchyma of tumor nephrectomies and frequently report incidences of new medical renal disease directly to clinicians, but there remains room for improvement and educational gaps during residency training. Further efforts to standardize both this evaluation and renal pathology education will improve patient care.
在肾癌患者的生存率提高后，治疗策略已转向优化肾功能的保留。2010 年，美国病理学家学院（CAP）更新了其肿瘤肾切除术的综合报告指南，要求评估非肿瘤性肾实质。我们进行这项研究是为了了解目前在肿瘤肾切除标本中评估非肿瘤性肾实质的实践行为。我们向肾脏病理学会和泌尿生殖病理学会的成员发送了一份 14 项多项选择的调查，我们还向美国病理住院医师计划的主任和副主任发送了一份 12 项调查，以评估肾脏病理教育的现状。98 名泌尿生殖病理学家和 104 名肾脏病理学家对非肿瘤性肾实质的调查做出了回应。95%的检查肿瘤肾切除术的受访者报告评估了非肿瘤性肾实质。75%的泌尿生殖病理学家和 67%的肾脏病理学家使用综合报告，81%的人使用 CAP 方案。39%的受访者报告当他们发现医学肾脏疾病的证据时，总是联系临床医生。42 名项目负责人对我们的肾脏病理教育调查做出了回应，其中 64%的人有强制性的肾脏病理轮转，平均持续约 2 到 4 周。大多数病理学家检查肿瘤肾切除术的非肿瘤性肾实质，并且经常直接向临床医生报告新的医学肾脏疾病的发生率，但在住院医师培训期间仍有改进和教育差距的空间。进一步努力规范这一评估和肾脏病理教育将改善患者的护理。
