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Review
Diagnostic procedures for non-small-cell lung cancer (NSCLC): recommendations of the European Expert Group
  1. Manfred Dietel1,
  2. Lukas Bubendorf2,
  3. Anne-Marie C Dingemans3,
  4. Christophe Dooms4,
  5. Göran Elmberger5,
  6. Rosa Calero García6,
  7. Keith M Kerr7,
  8. Eric Lim8,
  9. Fernando López-Ríos9,
  10. Erik Thunnissen10,
  11. Paul E Van Schil11,
  12. Maximilian von Laffert1
  1. 1Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
  2. 2Institute of Pathology, University Hospital Basel, Basel, Switzerland
  3. 3Department of Respiratory Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
  4. 4Respiratory Division, University Hospitals KU Leuven, Leuven, Belgium
  5. 5Department of Laboratory Medicine, Pathology, Örebro University Hospital, Örebro, Sweden
  6. 6Department of Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain
  7. 7Aberdeen University Medical School, Aberdeen, UK
  8. 8Academic Division of Thoracic Surgery, The Royal Brompton Hospital and Imperial College, London, UK
  9. 9Laboratorio de Dianas Terapéuticas, Hospital Universitario HM Sanchinarro, Madrid, Spain
  10. 10Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
  11. 11Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium
  1. Correspondence to Professor Manfred Dietel, Institute of Pathology, Charité Universitätsmedizin Berlin, Campus Charité, Charitéplatz 1, Berlin 10117, Germany; manfred.dietel{at}charite.de

Abstract

Background There is currently no Europe-wide consensus on the appropriate preanalytical measures and workflow to optimise procedures for tissue-based molecular testing of non-small-cell lung cancer (NSCLC). To address this, a group of lung cancer experts (see list of authors) convened to discuss and propose standard operating procedures (SOPs) for NSCLC.

Methods Based on earlier meetings and scientific expertise on lung cancer, a multidisciplinary group meeting was aligned. The aim was to include all relevant aspects concerning NSCLC diagnosis. After careful consideration, the following topics were selected and each was reviewed by the experts: surgical resection and sampling; biopsy procedures for analysis; preanalytical and other variables affecting quality of tissue; tissue conservation; testing procedures for epidermal growth factor receptor, anaplastic lymphoma kinase and ROS proto-oncogene 1, receptor tyrosine kinase (ROS1) in lung tissue and cytological specimens; as well as standardised reporting and quality control (QC). Finally, an optimal workflow was described.

Results Suggested optimal procedures and workflows are discussed in detail. The broad consensus was that the complex workflow presented can only be executed effectively by an interdisciplinary approach using a well-trained team.

Conclusions To optimise diagnosis and treatment of patients with NSCLC, it is essential to establish SOPs that are adaptable to the local situation. In addition, a continuous QC system and a local multidisciplinary tumour-type-oriented board are essential.

  • Non-Small Cell Lung Cancer
  • Histology/Cytology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/thoraxjnl-2014-206677

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