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Reproducibility of the peritoneal regression grading score for assessment of response to therapy in peritoneal metastasis
Author(s) -
Solass Wiebke,
Sempoux Christine,
Carr Norman J,
Bibeau Frederic,
Neureiter Daniel,
Jäger Tarkan,
Di Caterino Tina,
Brunel Christophe,
Klieser Eckhard,
Fristrup Claus W,
Mortensen Michael B,
Detlefsen Sönke
Publication year - 2019
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.13829
Subject(s) - medicine , biopsy , grading (engineering) , intraclass correlation , quadrant (abdomen) , reproducibility , radiology , surgery , statistics , psychometrics , clinical psychology , civil engineering , mathematics , engineering
Aims The four‐tiered peritoneal regression grading score ( PRGS ) assesses the response to chemotherapy in peritoneal metastasis ( PM ). The PRGS is used, for example, to assess the response to pressurised intraperitoneal aerosol chemotherapy ( PIPAC ). However, the reproducibility of the PRGS is currently unknown. We aimed to evaluate the inter‐ and intraobserver variability of the PRGS . Methods and results Thirty‐three patients who underwent at least three PIPAC treatments as part of the PIPAC ‐ OPC 1 or PIPAC ‐ OPC 2 clinical trials at Odense University Hospital, Denmark, were included. Prior to each therapy cycle, peritoneal quadrant biopsies were obtained and three haematoxylin and eosin (H&E)‐stained step sections were scanned and uploaded to a pseudonymised web library. For determining interobserver variability, eight pathologists assessed the PRGS for each quadrant biopsy, and Krippendorff's alpha and intraclass correlation coefficients ( ICC s) were calculated. For determining intraobserver variability, three pathologists repeated their own assessments and Cohen's kappa and ICC s were calculated. A total of 331 peritoneal biopsies were analysed. Interobserver variability for PRGS of each biopsy and for the mean and maximum PRGS per biopsy set was moderate to good/substantial. The intraobserver variability for PRGS of each biopsy and for the mean and maximum PRGS per biopsy set was good to excellent/almost perfect. Conclusions Our data support the PRGS as a reproducible and useful tool to assess response to intraperitoneal chemotherapy in PM. Future studies should evaluate the prognostic and predictive role of the PRGS .