TY - JOUR
T1 - Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens
AU - Evans, Andrew J.
AU - Henry, Pauline C.
AU - Van Der Kwast, Theodorus H.
AU - Tkachuk, Douglas C.
AU - Watson, Kemp
AU - Lockwood, Gina A.
AU - Fleshner, Neil E.
AU - Cheung, Carol
AU - Belanger, Eric C.
AU - Amin, Mahul B.
AU - Boccon-Gibod, Liliane
AU - Bostwick, David G.
AU - Egevad, Lars
AU - Epstein, Jonathan I.
AU - Grignon, David J.
AU - Jones, Edward C.
AU - Montironi, Rodolfo
AU - Moussa, Madeleine
AU - Sweet, Joan M.
AU - Trpkov, Kiril
AU - Wheeler, Thomas M.
AU - Srigley, John R.
PY - 2008/10
Y1 - 2008/10
N2 - Accurate Gleason score, pathologic stage, and surgical margin (SM) information is critical for the planning of post-radical prostatectomy management in patients with prostate cancer. Although interobserver variability for Gleason score among urologic pathologists has been well documented, such data for pathologic stage and SM assessment are limited. We report the first study to address interobserver variability in a group of expert pathologists concerning extraprostatic soft tissue (EPE) and SM interpretation for radical prostatectomy specimens. A panel of 3 urologic pathologists selected 6 groups of 10 slides designated as being positive, negative, or equivocal for either EPE or SM based on unanimous agreement. Twelve expert urologic pathologists, who were blinded to the panel diagnoses, reviewed 40× whole-slide scans and provided diagnoses for EPE and SM on each slide. On the basis of panel diagnoses, as the gold standard, specificity, sensitivity, and accuracy values were high for both EPE (87.5%, 95.0%, and 91.2%) and SM (97.5%, 83.3%, and 90.4%). Overall κ values for all 60 slides were 0.74 for SM and 0.63 for EPE. The κ values were higher for slides with definitive gold standard EPE (κ=0.81) and SM (κ=0.73) diagnoses when compared with the EPE (κ=0.29) and SM (κ=0.62) equivocal slides. This difference was markedly pronounced for EPE. Urologic pathologists show good to excellent agreement when evaluating EPE and SM. Interobserver variability for EPE and SM interpretation was principally related to the lack of a clearly definable prostatic capsule and crush/thermal artifact along the edge of the gland, respectively.
AB - Accurate Gleason score, pathologic stage, and surgical margin (SM) information is critical for the planning of post-radical prostatectomy management in patients with prostate cancer. Although interobserver variability for Gleason score among urologic pathologists has been well documented, such data for pathologic stage and SM assessment are limited. We report the first study to address interobserver variability in a group of expert pathologists concerning extraprostatic soft tissue (EPE) and SM interpretation for radical prostatectomy specimens. A panel of 3 urologic pathologists selected 6 groups of 10 slides designated as being positive, negative, or equivocal for either EPE or SM based on unanimous agreement. Twelve expert urologic pathologists, who were blinded to the panel diagnoses, reviewed 40× whole-slide scans and provided diagnoses for EPE and SM on each slide. On the basis of panel diagnoses, as the gold standard, specificity, sensitivity, and accuracy values were high for both EPE (87.5%, 95.0%, and 91.2%) and SM (97.5%, 83.3%, and 90.4%). Overall κ values for all 60 slides were 0.74 for SM and 0.63 for EPE. The κ values were higher for slides with definitive gold standard EPE (κ=0.81) and SM (κ=0.73) diagnoses when compared with the EPE (κ=0.29) and SM (κ=0.62) equivocal slides. This difference was markedly pronounced for EPE. Urologic pathologists show good to excellent agreement when evaluating EPE and SM. Interobserver variability for EPE and SM interpretation was principally related to the lack of a clearly definable prostatic capsule and crush/thermal artifact along the edge of the gland, respectively.
KW - Extraprostatic extension
KW - Interobserver variability
KW - Prostate cancer
KW - Radical prostatectomy
KW - Surgical margins
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U2 - 10.1097/PAS.0b013e31817fb3a0
DO - 10.1097/PAS.0b013e31817fb3a0
M3 - Article
C2 - 18708939
AN - SCOPUS:53449094360
SN - 0147-5185
VL - 32
SP - 1503
EP - 1512
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
IS - 10
ER -