TY - JOUR
T1 - Accuracy of Grading Gleason Score 7 Prostatic Adenocarcinoma on Needle Biopsy
T2 - Influence of Percent Pattern 4 and Other Histological Factors
AU - Meliti, Abdelrazak
AU - Sadimin, Evita
AU - Diolombi, Mario
AU - Khani, Francesca
AU - Epstein, Jonathan I.
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - BACKGROUND: Recognition of Gleason pattern 4 in prostatic needle biopsies is crucial for both prognosis and therapy. Recently, it has been recommended to record percent pattern 4 when Gleason score 7 cancer is the highest grade in a case. METHODS: Four hundred and five prostate needle core biopsies received for a second opinion at our institution from February–June, 2015 were prospectively diagnosed with prostatic adenocarcinoma Gleason score 7 as the highest score on review by a consultant urological pathologist. Percentage of core involvement by cancer, percentage of Gleason pattern 4 per core, distribution of Gleason pattern 4 (clustered, scattered), morphology of pattern 4 (cribriform, non-cribriform), and whether the cancer was continuous or discontinuous were recorded. RESULTS: Better agreement was noted between the consultant and referring pathologists when pattern 4 was clustered as opposed to dispersed in biopsies (P = 0.009). The percentage of core involvement by cancer, morphology of pattern 4, and continuity of cancer did not affect the agreement between the consultant and referring pathologists. There was a trend (P = 0.06) for better agreement based on the percent of pattern 4. CONCLUSIONS: When pattern 4 is scattered amongst pattern 3 as opposed to being discrete foci, there is less interobserver reproducibility in grading Gleason score 7 cancer, and in this setting pathologists should consider obtaining second opinions either internally within their group or externally. Prostate 77: 681–685, 2017.
AB - BACKGROUND: Recognition of Gleason pattern 4 in prostatic needle biopsies is crucial for both prognosis and therapy. Recently, it has been recommended to record percent pattern 4 when Gleason score 7 cancer is the highest grade in a case. METHODS: Four hundred and five prostate needle core biopsies received for a second opinion at our institution from February–June, 2015 were prospectively diagnosed with prostatic adenocarcinoma Gleason score 7 as the highest score on review by a consultant urological pathologist. Percentage of core involvement by cancer, percentage of Gleason pattern 4 per core, distribution of Gleason pattern 4 (clustered, scattered), morphology of pattern 4 (cribriform, non-cribriform), and whether the cancer was continuous or discontinuous were recorded. RESULTS: Better agreement was noted between the consultant and referring pathologists when pattern 4 was clustered as opposed to dispersed in biopsies (P = 0.009). The percentage of core involvement by cancer, morphology of pattern 4, and continuity of cancer did not affect the agreement between the consultant and referring pathologists. There was a trend (P = 0.06) for better agreement based on the percent of pattern 4. CONCLUSIONS: When pattern 4 is scattered amongst pattern 3 as opposed to being discrete foci, there is less interobserver reproducibility in grading Gleason score 7 cancer, and in this setting pathologists should consider obtaining second opinions either internally within their group or externally. Prostate 77: 681–685, 2017.
KW - gleason grading
KW - interobserver
KW - percent pattern 4
KW - prostate cancer
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U2 - 10.1002/pros.23314
DO - 10.1002/pros.23314
M3 - Article
C2 - 28155999
AN - SCOPUS:85012975364
SN - 0270-4137
VL - 77
SP - 681
EP - 685
JO - Prostate
JF - Prostate
IS - 6
ER -