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The reasons behind variation in G leason grading of prostatic biopsies: areas of agreement and misconception among 266 E uropean pathologists
Author(s) -
Berney Daniel M,
Algaba Ferran,
Camparo Philippe,
Compérat Eva,
Griffiths David,
Kristiansen Glen,
LopezBeltran Antonio,
Montironi Rodolfo,
Varma Murali,
Egevad Lars
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12284
Subject(s) - medicine , grading (engineering) , biopsy , prostatectomy , prostate cancer , needle biopsy , urology , radiology , cancer , civil engineering , engineering
Aims The G leason scoring system underwent revision at the I nternational S ociety of U rological Pathology ( ISUP ) conference in 2005. It is not known how uropathologists have interpreted its recommendations. Method and results A web‐based survey to E uropean N etwork of U ropathology members received replies from 266 pathologists in 22 countries. Eighty‐nine per cent claimed to follow ISUP recommendations. Key areas of disagreement included the following. Smoothly rounded cribriform glands were assigned G leason pattern ( GP ) 3 by 51% and GP 4 by 49%. Necrosis was diagnosed as GP 5 by 62%. Any amount of secondary pattern of higher grade in needle biopsies was included in the G leason score by 58%. Tertiary GP of higher grade on needle biopsies was included in the G leason score by only 58%. If biopsy cores were embedded separately, only 56% would give a G leason score for each core/slide examined; 68% would give a concluding G leason score and the most common method was a global G leason score (77%). Among those who blocked multiple biopsy cores together, 46% would only give an overall G leason score for the case. Conclusion Misinterpretation of ISUP 2005 is widespread, and may explain the variation in G leason scoring seen. Clarity and uniformity in teaching ISUP 2005 recommendations is necessary.