Standardization of Gleason grading among 337 European pathologists
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Standardization of Gleason grading among 337 European pathologists. / Egevad, Lars; Ahmad, Amar S; Algaba, Ferran; Berney, Daniel M; Boccon-Gibod, Liliane; Compérat, Eva; Evans, Andrew J; Griffiths, David; Grobholz, Rainer; Kristiansen, Glen; Langner, Cord; Lopez-Beltran, Antonio; Montironi, Rodolfo; Moss, Sue; Oliveira, Pedro; Vainer, Ben; Varma, Murali; Camparo, Philippe.
In: Histopathology, Vol. 62, No. 2, 01.2013, p. 247-56.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Standardization of Gleason grading among 337 European pathologists
AU - Egevad, Lars
AU - Ahmad, Amar S
AU - Algaba, Ferran
AU - Berney, Daniel M
AU - Boccon-Gibod, Liliane
AU - Compérat, Eva
AU - Evans, Andrew J
AU - Griffiths, David
AU - Grobholz, Rainer
AU - Kristiansen, Glen
AU - Langner, Cord
AU - Lopez-Beltran, Antonio
AU - Montironi, Rodolfo
AU - Moss, Sue
AU - Oliveira, Pedro
AU - Vainer, Ben
AU - Varma, Murali
AU - Camparo, Philippe
N1 - © 2012 Blackwell Publishing Limited.
PY - 2013/1
Y1 - 2013/1
N2 - AIMS: The 2005 International Society of Urological Pathology (ISUP) modification of Gleason grading recommended that the highest grade should always be included in the Gleason score (GS) in prostate biopsies. We analysed the impact of this recommendation on reporting of GS 6 versus 7.METHODS AND RESULTS: Fifteen expert uropathologists reached two-thirds consensus on 15 prostate biopsies with GS 6-7 cancer. Eighty-five microphotographs were graded by 337 of 617 members of the European Network of Uropathology (ENUP), representing 19 countries. There was agreement between expert and majority member GS in 12 of 15 cases, while members upgraded in three cases. Among members and the expert consensus, a GS >6 was assigned by 64.5% and 60%, respectively. Mean member GS was higher than consensus GS in nine of 15 cases. A Gleason pattern (GP) 5 was reported by 0.3-5.6% in 10 cases. Agreement between consensus and member GS was 58.2-89.3% (mean 71.4%) in GS 6 cases and 46.3-63.8% (mean 56.4%) in GS 7 cases (P = 0.009).CONCLUSIONS: While undergrading of prostate cancer used to be prevalent, some now tend to overgrade. Minimum diagnostic criteria for GP 4 and 5 in biopsies need to be better defined. Image libraries reviewed by experts may be useful for standardization.
AB - AIMS: The 2005 International Society of Urological Pathology (ISUP) modification of Gleason grading recommended that the highest grade should always be included in the Gleason score (GS) in prostate biopsies. We analysed the impact of this recommendation on reporting of GS 6 versus 7.METHODS AND RESULTS: Fifteen expert uropathologists reached two-thirds consensus on 15 prostate biopsies with GS 6-7 cancer. Eighty-five microphotographs were graded by 337 of 617 members of the European Network of Uropathology (ENUP), representing 19 countries. There was agreement between expert and majority member GS in 12 of 15 cases, while members upgraded in three cases. Among members and the expert consensus, a GS >6 was assigned by 64.5% and 60%, respectively. Mean member GS was higher than consensus GS in nine of 15 cases. A Gleason pattern (GP) 5 was reported by 0.3-5.6% in 10 cases. Agreement between consensus and member GS was 58.2-89.3% (mean 71.4%) in GS 6 cases and 46.3-63.8% (mean 56.4%) in GS 7 cases (P = 0.009).CONCLUSIONS: While undergrading of prostate cancer used to be prevalent, some now tend to overgrade. Minimum diagnostic criteria for GP 4 and 5 in biopsies need to be better defined. Image libraries reviewed by experts may be useful for standardization.
KW - Adenocarcinoma
KW - Biopsy
KW - Consensus
KW - Europe
KW - Humans
KW - Male
KW - Neoplasm Grading
KW - Observer Variation
KW - Pathology, Surgical
KW - Prostatic Neoplasms
KW - Reproducibility of Results
U2 - 10.1111/his.12008
DO - 10.1111/his.12008
M3 - Journal article
C2 - 23240715
VL - 62
SP - 247
EP - 256
JO - Histopathology
JF - Histopathology
SN - 0309-0167
IS - 2
ER -
ID: 117547094