Supplementary Material for: Cancer Reporting Protocols in transurethral resection of bladder tumor (TURBT) – standardized reporting of bladder cancer and improvement of communication between pathologists and urologists

Introduction: The College of American Pathologists (CAP) provides synoptic reporting (SR) histopathological protocols for various malignancies e.g. for bladder cancer. We investigated whether SR can enhance the quality of histopathological reporting at our institution. Specifically, we examined whether SR supports pathologists in report preparation and whether urologists of varying training levels fully understand the histopathological information in narrative reports (NR). Methods: We investigated the transcription of semantic reports into synoptic CAP protocols by pathologists and clinicians. Through retrospective evaluation, 187 NR were re-evaluated using a CAP protocol by a senior pathologist to assess reporting quality and completeness. Additionally, 50 NR were independently transcribed into synoptic protocols by a resident trainee and board-certified urologists to evaluate clinical adoption. Results: SR demonstrated advantages in detailing specific pathological features, especially rare variants and tumor characteristics, despite high overall concordance between formats. Diagnostic accuracy improved with clinical experience, with uro-oncologist and department head outperforming the urology resident. Conclusions: SR has the potential to improve the communication between pathologists and urologists and enhance the quality of care. It also increased standardization and minimized omissions, highlighting its potential to reduce or eliminate information loss.