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• W3147979078 abstract "Multi-institutional collaborations such as that reported by Allison et al1 are valuable resources for the cytopathology community. Such studies have the capacity to recruit a large and diverse study population, with the goal of generating data that have the potential to be more broadly applicable than those from single-institution studies. We appreciate the authors' efforts at curating their multi-institutional data set of fine-needle aspiration samples with a cytologic differential or definite diagnosis of pleomorphic adenoma (PA) or Warthin tumor (WT) with matched resection specimens. However, in view of the study design, we were uncertain regarding several of the conclusions drawn from this data set. The authors searched for cases for this study in 2 ways: 1) a “forward search” that identified fine-needle aspiration cases with a differential or definitive diagnosis of PA or WT; and 2) a “backward search” that identified cases with a final diagnosis of PA or WT on surgical resection. A data set built by combining these 2 search strategies is problematic from the standpoint of calculating risk of malignancy (ROM) or diagnostic accuracy because the backward search necessarily inflates the data set with cases that have histologically confirmed benign reference diagnoses. Accordingly, we were concerned that the authors' report of a low ROM (2.7%) for aspiration samples classified as “salivary gland neoplasm of uncertain malignant potential” (SUMP) with a differential diagnosis of PA, although unsurprising in light of the selection criteria, was potentially misleading. Although the authors acknowledged selection bias as a possible explanation for the low ROM for SUMP with a differential diagnosis of PA, it is important to point out that the low ROM derived in this data set may not be generalizable to cases in our cytopathology practice that we classify as such. If the authors are able to analyze their data after excluding those cases identified by their backward search strategy, they may be able to provide more clinically relevant estimates of ROM and diagnostic accuracy for SUMP with PA in the differential diagnosis. On a related note, we also found the authors' statement that “these findings highlight the difference in the ROMs associated with 2 specific differential diagnoses in the SUMP category: basaloid neoplasms and oncocytoid neoplasms”1 to be perplexing. As the authors described, the selection criteria for their study specifically enriched for cases with cytologic features or a diagnosis of PA or WT.1 Consequently, the data could not be extrapolated to represent ROMs associated with all aspiration samples classified as basaloid or oncocytoid SUMP. No specific funding was disclosed. The authors made no disclosures." @default.
• W3147979078 created "2021-04-13" @default.
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• W3147979078 date "2020-12-01" @default.
• W3147979078 modified "2023-10-03" @default.
• W3147979078 title "Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan System for Reporting Salivary Gland Cytopathology: An international, multi‐institutional study" @default.
• W3147979078 cites W4235306914 @default.
• W3147979078 doi "https://doi.org/10.1002/cncy.22392" @default.
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