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 -