# Implementation of Synoptic Reports in Enhancing Documentation Practices in Pediatric Surgical Oncology: A Systematic Review

## TL;DR

This paper reviews how structured synoptic reports improve documentation in pediatric cancer surgery compared to traditional narrative reports.

## Contribution

The study systematically evaluates the effectiveness of synoptic reports in pediatric surgical oncology, highlighting a critical translational gap.

## Key findings

- Synoptic reports show tenfold higher odds of complete documentation compared to narrative reports.
- Structured reports improve communication and support treatment planning in pediatric oncology.
- Adoption of synoptic reports in pediatric surgery remains limited despite proven benefits.

## Abstract

Operative reports are critical documents that describe what surgeons observe and perform during cancer surgery. In children with solid tumors, these details are particularly important because intraoperative findings often determine disease stage, risk classification, and treatment decisions. However, traditional narrative operative reports are written as free text and may omit important information needed by oncologists, pathologists, and multidisciplinary teams. Synoptic operative reports use structured templates that prompt surgeons to record key oncologic findings in a standardized format. In this systematic review, we evaluated existing studies comparing synoptic and narrative operative reports in pediatric surgical oncology. The available evidence shows that structured synoptic reports consistently capture more complete and clinically relevant information. These findings suggest that standardized operative documentation may improve communication, support treatment planning, and enhance the quality of surgical data used for research and international collaboration in childhood cancer care.

Purpose: Despite extensive evidence supporting synoptic reporting in adult surgical oncology, the pediatric surgical oncology evidence base remains sparse, institution-dependent, and implementation-limited, resulting in a critical translational gap. This systematic review evaluates the implementation and effectiveness of synoptic operative reports (SR) in improving documentation completeness in pediatric oncology surgery compared with traditional narrative reports (NR). Methods: Prospective and retrospective studies evaluating operative report completeness in pediatric oncology surgery were identified through a comprehensive search of PubMed, Scopus, and Web of Science. Of 1926 screened records, 11 articles underwent full-text review, and 4 studies met inclusion criteria. Results: The four included studies analyzed 341 operative reports (217 NRs and 124 SRs). Documentation completeness was the primary outcome. Across all evaluated intraoperative elements, synoptic reports were associated with approximately tenfold higher odds of complete documentation compared with narrative reports (pooled OR for NR vs. SR, 0.10; 95% CI, 0.07–0.14; p < 0.001). Conclusions: Synoptic reporting consistently improves the completeness of pediatric oncologic operative documentation compared with narrative formats; however, adoption in pediatric surgical oncology remains limited. Multicenter and implementation-focused research is needed to assess scalability, integration within electronic medical record (EMR) systems, and the impact of synoptic reporting on communication and clinical decision-making.