Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens

Andrew J. Evans, Pauline C. Henry, Theodorus H. Van Der Kwast, Douglas C. Tkachuk, Kemp Watson, Gina A. Lockwood, Neil E. Fleshner, Carol Cheung, Eric C. Belanger, Mahul B. Amin, Liliane Boccon-Gibod, David G. Bostwick, Lars Egevad, Jonathan I. Epstein, David Grignon, Edward C. Jones, Rodolfo Montironi, Madeleine Moussa, Joan M. Sweet, Kiril Trpkov & 2 others Thomas M. Wheeler, John R. Srigley

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1503-1512
Number of pages10
JournalAmerican Journal of Surgical Pathology
Volume32
Issue number10
DOIs
StatePublished - Oct 2008

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Observer Variation
Prostatectomy
Neoplasm Grading
Pathologists
Margins of Excision
Artifacts
Capsules
Prostatic Neoplasms
Hot Temperature

Keywords

  • Extraprostatic extension
  • Interobserver variability
  • Prostate cancer
  • Radical prostatectomy
  • Surgical margins

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery
  • Medicine(all)

Cite this

Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens. / Evans, Andrew J.; Henry, Pauline C.; Van Der Kwast, Theodorus H.; Tkachuk, Douglas C.; Watson, Kemp; Lockwood, Gina A.; Fleshner, Neil E.; Cheung, Carol; Belanger, Eric C.; Amin, Mahul B.; Boccon-Gibod, Liliane; Bostwick, David G.; Egevad, Lars; Epstein, Jonathan I.; Grignon, David; Jones, Edward C.; Montironi, Rodolfo; Moussa, Madeleine; Sweet, Joan M.; Trpkov, Kiril; Wheeler, Thomas M.; Srigley, John R.

In: American Journal of Surgical Pathology, Vol. 32, No. 10, 10.2008, p. 1503-1512.

Research output: Contribution to journalArticle

Evans, AJ, Henry, PC, Van Der Kwast, TH, Tkachuk, DC, Watson, K, Lockwood, GA, Fleshner, NE, Cheung, C, Belanger, EC, Amin, MB, Boccon-Gibod, L, Bostwick, DG, Egevad, L, Epstein, JI, Grignon, D, Jones, EC, Montironi, R, Moussa, M, Sweet, JM, Trpkov, K, Wheeler, TM & Srigley, JR 2008, 'Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens', American Journal of Surgical Pathology, vol. 32, no. 10, pp. 1503-1512. https://doi.org/10.1097/PAS.0b013e31817fb3a0
Evans, Andrew J. ; Henry, Pauline C. ; Van Der Kwast, Theodorus H. ; Tkachuk, Douglas C. ; Watson, Kemp ; Lockwood, Gina A. ; Fleshner, Neil E. ; Cheung, Carol ; Belanger, Eric C. ; Amin, Mahul B. ; Boccon-Gibod, Liliane ; Bostwick, David G. ; Egevad, Lars ; Epstein, Jonathan I. ; Grignon, David ; Jones, Edward C. ; Montironi, Rodolfo ; Moussa, Madeleine ; Sweet, Joan M. ; Trpkov, Kiril ; Wheeler, Thomas M. ; Srigley, John R. / Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens. In: American Journal of Surgical Pathology. 2008 ; Vol. 32, No. 10. pp. 1503-1512.
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AU - Henry, Pauline C.

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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

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AU - Grignon, David

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