Standards, Options et Recommandations : bonne pratique de l'acheminement et de la prise en charge initiale d'un prélèvement en anatomie et cytologie pathologiques en cancérologie

Context: The "Standards, Options and Recommendations" (SOR) collaborative project was initiated in 1993 by the Federation of the French Cancer Centres (FNCLCC), with the 20 French Regional Cancer Centres, several French public university and general hospitals, as well as private clinics and medical speciality societies. Its main objective is the development of serviceable clinical practice guidelines in order to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review, followed by critical appraisal by a multidisciplinary group of experts. Draft guidelines are produced, then validated by specialists in cancer care delivery. Objectives: Produce clinical practice guidelines for the management and shipment of histological and cytopathological cancer specimens using the methodology developed by the Standards, Options and Recommendations project. Methods: The FNCLCC designated the group of experts. Available data were collected by a search of Medline® and lists selected by experts in the group. A first draft of the guidelines was written, they validated by independent reviewers. Results: The main recommendations are: 1) high-quality transmission of information between professionals is essential to the management of cancer specimens in order to assure high-quality diagnosis and evaluation of prognostic factors; 2) written procedures concerning sample shipment, handling, storage, registration, tracking and fixation exist; these procedures, as well as the necessary shipping material, will be sent to all clinical services involved; 3) when possible, fresh, unfractionated, oriented surgical samples will be submitted to the same histological and cytopathological laboratory; 4) samples collected for extemporaneous examination, freezing or cell culture must be shipped immediately under appropriate storage conditions; 5) Once frozen, samples can be stored in a deep freezer at temperatures of ­ 80° C or below, or kept in liquid nitrogen; 6) fixing tissues shortly after sample collection is essential to prevent cell lysis; 7) computerised systems will be used to assure correct specimen registration and tracking in histological and cytopathological laboratories.