Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer.
Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at...
| Publicado en: | Virchows Archiv: European Journal of Pathology Vol. 476; no. 2; pp. 219 - 231 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Feb2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141807680&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141807680 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09456317 O1Z jtl: Virchows Archiv: European Journal of Pathology issn: 09456317 maglogo: N pubinfo: dt: Feb2020 vid: 476 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 141807680 141807680 NLM31616981 141807680 10.1007/s00428-019-02663-0 NLM31616981 141807680 ppf: 219 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer. aug: au: Klaver, Charlotte E. L. Bulkmans, Nicole Drillenburg, Paul Grabsch, Heike I. van Grieken, Nicole C. T. Karrenbeld, Arend Koens, Lianne van Lijnschoten, Ineke Meijer, Jos Nagtegaal, Iris D. Sagaert, Xavier Seldenrijk, Kees van Velthuysen, M. F. Bruggink, Annette H. Tanis, Pieter J. Snaebjornsson, Petur affil: Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands sug: subj: Peritoneum Pathology Adenocarcinoma Pathology Neoplasm Metastasis Pathology Colonic Neoplasms Pathology Prognosis Retrospective Design Adenocarcinoma Diagnosis Observer Bias Colonic Neoplasms Diagnosis Neoplasm Invasiveness Pathology Scales ab: Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at a distance of 25-1500 μm (n = 22), 0-25 μm (n = 22), or on (n = 22) the peritoneal surface. Inter- and intraobserver variability were calculated using Kappa statistics. For interlaboratory variability, pathology reports of pT3 and pT4a colon cancer were extracted from the Dutch Pathology Registry between 2012 and 2015. The proportion of pT4a (pT4a/(pT3+pT4a)) was compared between 33 laboratories. Potential risk of understaging was assessed by determining the average number of blocks taken from pT3 and pT4a N0-2M0 tumors with metachronous peritoneal metastasis. Interobserver variability among 12 pathologists was 0.50 (95%CI 0.41-0.60; moderate agreement). Intraobserver variability (8 pathologists) was 0.71 (substantial agreement). A total of 7745 reports with pT3 or pT4aN0-2M0 colon cancer from 33 laboratories were included for interlaboratory analysis. Median percentage of pT4a was 15.5% (range 3.2-24.6%). After adjustment for case mix, 8 labs diagnosed pT4a significantly less or more frequently than the median lab. Metachronous peritoneal metastases were histologically verified in 170 of 6629 pT3 and in 129 of 1116 pT4a tumors, with a mean number of blocks of 4.03(SD 1.51) and 4.78 (SD 1.76) taken from the primary tumors, respectively (p < 0.001). A substantial variability in diagnosing pT4a colon cancer exists, both at pathologist and laboratory level. Diagnosis of pT4a stage appears to be challenging and there is a need for standardizing assessment of this pathological entity. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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