Low level of interobserver concordance in assessing histological subtype and tumor grade in patients with penile cancer may impair patient care

Differentiation between penile squamous cell carcinoma patients who can benefit from limited organ-sparing surgery and those at significant risk of lymph node metastasis is based on histopathological prognostic factors including histological grade and tumor histological subtype. We examined levels o...

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Vydáno v:Virchows Archiv : an international journal of pathology Ročník 480; číslo 4; s. 879 - 886
Hlavní autoři: Dorofte, Luiza, Grélaud, Diane, Fiorentino, Michelangelo, Giunchi, Francesca, Ricci, Costantino, Franceschini, Tania, Riefolo, Mattia, Davidsson, Sabina, Carlsson, Jessica, Lillsunde Larsson, Gabriella, Karlsson, Mats G.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2022
Springer Nature B.V
Témata:
Cancer
Carcinoma, Squamous Cell - pathology
Cell differentiation
Genital cancers
Histological grading
Humans
Interobserver agreement
Lymph nodes
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Metastases
Observer Variation
Original
Original Article
Pathology
Patient Care
Patients
Penile cancer
Penile carcinoma subtypes
Penile Neoplasms - pathology
Penis
Squamous cell carcinoma
Tumors
Histological grading
Penile cancer
Interobserver agreement
Penile carcinoma subtypes
ISSN:0945-6317, 1432-2307, 1432-2307
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Shrnutí:Differentiation between penile squamous cell carcinoma patients who can benefit from limited organ-sparing surgery and those at significant risk of lymph node metastasis is based on histopathological prognostic factors including histological grade and tumor histological subtype. We examined levels of interobserver and intraobserver agreement in assessment of histological subtype and grade in 207 patients with penile squamous cell carcinoma. The cases were assessed by seven pathologists from three hospitals located in Sweden and Italy. There was poor to moderate concordance in assessing both histological subtype and grade, with Fleiss kappas of 0.25 (range: 0.02–0.48) and 0.23 (range: 0.07–0.55), respectively. When choosing HPV-associated and non-HPV-associated subtypes, interobserver concordance ranged from poor to good, with a Fleiss kappa value of 0.36 (range: 0.02–0.79). A re-review of the slides by two of the pathologists showed very good intraobserver concordance in assessing histological grade and subtype, with Cohen’s kappa values of 0.94 and 0.91 for grade and 0.95 and 0.84 for subtype. Low interobserver concordance could lead to undertreatment and overtreatment of many patients with penile cancer, and brings into question the utility of tumor histological subtype and tumor grade in determining patient treatment in pT1 tumors.
Bibliografie:ObjectType-Article-1
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ISSN:0945-6317
1432-2307
1432-2307
DOI:10.1007/s00428-021-03249-5