Prospective study of the accuracy of the surgeon's diagnosis in 2000 excised skin tumors

Plastic and Reconstructive Surgery
G G Hallock, D A Lutz

Abstract

Expeditious yet efficacious removal of skin tumors is a common responsibility for the plastic surgeon. The need to minimize potential risks for mortality or morbidity from undue or excessive surgical resections and to control costs by avoiding unnecessary procedures behooves us to make a precise clinical diagnosis preceding any decision even for such "minor" surgery. Just how accurate these decisions can be expected to be for a typical surgical practice was scrutinized by means of this prospective 4-year study involving the resection of 2058 skin lesions. Each lesion was initially assigned a clinical diagnosis after a brief gross examination and then compared with the pathology report, which was always considered to be the correct answer. Within these parameters, only 65 percent of all tumors were identified correctly preoperatively. Two-thirds of all lesions were benign. Three-quarters of benign lesions were as assumed, and 92 percent of all presumed benign lesions were benign even if incorrectly identified initially, whereas fortunately only 3 percent proved to be malignant. On the other hand, only three-fifths of malignant lesions were identified correctly clinically, yet only 11 percent were benign, implying that most such ...Continue Reading

References

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Citations

Aug 22, 2007·Archives of Dermatology·Karyn B StitzenbergRobert C Millikan
Jul 2, 2003·Plastic and Reconstructive Surgery·Damon J ThomasBruce G Peat
Jun 21, 2005·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Jordan B SchwartzbergRobert S Kirsner
Oct 2, 2007·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Mette Mogensen, Gregor B E Jemec
May 20, 2008·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Michael F Zide
Jun 28, 2003·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Tamara S HousmanG John Chen
Aug 17, 2020·Microscopy Research and Technique·Sadia MalikHafeez Ullah
Jul 31, 2014·Journal of the European Academy of Dermatology and Venereology : JEADV·G GualdiF Fantini

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