TY - JOUR
T1 - Revision of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis Classification Schema for Melanocytic Lesions
T2 - A Consensus Statement
AU - Barnhill, Raymond L.
AU - Elder, David E.
AU - Piepkorn, Michael W.
AU - Knezevich, Stevan R.
AU - Reisch, Lisa M.
AU - Eguchi, Megan M.
AU - Bastian, Boris C.
AU - Blokx, Willeke
AU - Bosenberg, Marcus
AU - Busam, Klaus J.
AU - Carr, Richard
AU - Cochran, Alistair
AU - Cook, Martin G.
AU - Duncan, Lyn M.
AU - Elenitsas, Rosalie
AU - De La Fouchardière, Arnaud
AU - Gerami, Pedram
AU - Johansson, Iva
AU - Ko, Jennifer
AU - Landman, Gilles
AU - Lazar, Alexander J.
AU - Lowe, Lori
AU - Massi, Daniela
AU - Messina, Jane
AU - Mihic-Probst, Daniela
AU - Parker, Douglas C.
AU - Schmidt, Birgitta
AU - Shea, Christopher R.
AU - Scolyer, Richard A.
AU - Tetzlaff, Michael
AU - Xu, Xiaowei
AU - Yeh, Iwei
AU - Zembowicz, Artur
AU - Elmore, Joann G.
N1 - Publisher Copyright:
© 2023 American Medical Association. All rights reserved.
PY - 2023/1/11
Y1 - 2023/1/11
N2 - Importance: A standardized pathology classification system for melanocytic lesions is needed to aid both pathologists and clinicians in cataloging currently existing diverse terminologies and in the diagnosis and treatment of patients. The Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) has been developed for this purpose. Objective: To revise the MPATH-Dx version 1.0 classification tool, using feedback from dermatopathologists participating in the National Institutes of Health-funded Reducing Errors in Melanocytic Interpretations (REMI) Study and from members of the International Melanoma Pathology Study Group (IMPSG). Evidence Review: Practicing dermatopathologists recruited from 40 US states participated in the 2-year REMI study and provided feedback on the MPATH-Dx version 1.0 tool. Independently, member dermatopathologists participating in an IMPSG workshop dedicated to the MPATH-Dx schema provided additional input for refining the MPATH-Dx tool. A reference panel of 3 dermatopathologists, the original authors of the MPATH-Dx version 1.0 tool, integrated all feedback into an updated and refined MPATH-Dx version 2.0. Findings: The new MPATH-Dx version 2.0 schema simplifies the original 5-class hierarchy into 4 classes to improve diagnostic concordance and to provide more explicit guidance in the treatment of patients. This new version also has clearly defined histopathological criteria for classification of classes I and II lesions; has specific provisions for the most frequently encountered low-cumulative sun damage pathway of melanoma progression, as well as other, less common World Health Organization pathways to melanoma; provides guidance for classifying intermediate class II tumors vs melanoma; and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as neoplasms lacking criteria for melanoma. Conclusions and Relevance: The implementation of the newly revised MPATH-Dx version 2.0 schema into clinical practice is anticipated to provide a robust tool and adjunct for standardized diagnostic reporting of melanocytic lesions and management of patients to the benefit of both health care practitioners and patients.
AB - Importance: A standardized pathology classification system for melanocytic lesions is needed to aid both pathologists and clinicians in cataloging currently existing diverse terminologies and in the diagnosis and treatment of patients. The Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) has been developed for this purpose. Objective: To revise the MPATH-Dx version 1.0 classification tool, using feedback from dermatopathologists participating in the National Institutes of Health-funded Reducing Errors in Melanocytic Interpretations (REMI) Study and from members of the International Melanoma Pathology Study Group (IMPSG). Evidence Review: Practicing dermatopathologists recruited from 40 US states participated in the 2-year REMI study and provided feedback on the MPATH-Dx version 1.0 tool. Independently, member dermatopathologists participating in an IMPSG workshop dedicated to the MPATH-Dx schema provided additional input for refining the MPATH-Dx tool. A reference panel of 3 dermatopathologists, the original authors of the MPATH-Dx version 1.0 tool, integrated all feedback into an updated and refined MPATH-Dx version 2.0. Findings: The new MPATH-Dx version 2.0 schema simplifies the original 5-class hierarchy into 4 classes to improve diagnostic concordance and to provide more explicit guidance in the treatment of patients. This new version also has clearly defined histopathological criteria for classification of classes I and II lesions; has specific provisions for the most frequently encountered low-cumulative sun damage pathway of melanoma progression, as well as other, less common World Health Organization pathways to melanoma; provides guidance for classifying intermediate class II tumors vs melanoma; and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as neoplasms lacking criteria for melanoma. Conclusions and Relevance: The implementation of the newly revised MPATH-Dx version 2.0 schema into clinical practice is anticipated to provide a robust tool and adjunct for standardized diagnostic reporting of melanocytic lesions and management of patients to the benefit of both health care practitioners and patients.
UR - http://www.scopus.com/inward/record.url?scp=85146192942&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85146192942&partnerID=8YFLogxK
U2 - 10.1001/jamanetworkopen.2022.50613
DO - 10.1001/jamanetworkopen.2022.50613
M3 - Review article
C2 - 36630138
AN - SCOPUS:85146192942
SN - 2574-3805
VL - 6
SP - E2250613
JO - JAMA Network Open
JF - JAMA Network Open
IS - 1
ER -