Premium
Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re‐evaluation
Author(s) -
BERG KASPER DRIMER,
TOFT BIRGITTE GRØNKÆR,
RØDER MARTIN ANDREAS,
BRASSO KLAUS,
VAINER BEN,
IVERSEN PETER
Publication year - 2011
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1600-0463.2011.02723.x
Subject(s) - medicine , prostatectomy , histopathology , concordance , prostate cancer , grading (engineering) , biopsy , prostate , histopathological examination , radiology , urology , pathology , cancer , civil engineering , engineering
Berg KD, Toft BG, Røder MA, Brasso K, Vainer B, Iversen P. Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re‐evaluation. APMIS 2011; 119: 239–46. Histopathological grading of prostate cancer (PCa) is associated with significant interobserver variability. This, as well as clinical consequences of histopathological re‐evaluation, was investigated. In 350 patients, histopathological re‐evaluations of prostate biopsies were compared with primary pathology reports and with histopathology of the radical prostatectomy specimen. The consequences of re‐evaluation for clinical workup and treatment of patients according to local algorithms were determined. For Gleason score (GS), complete agreement between primary report and re‐evaluation was found in 76.9%. The cancers were assessed with higher GS at re‐evaluation in 25.0% of patients in cases with primary GS ≤ 6, while scores were devaluated in 3.0% and 10.3% of the patients with primary GS = 7 and ≥8, respectively. Strategies for clinical evaluation and treatment were changed as a result of the biopsy re‐evaluations in 19.7% and 13.1% of patients, respectively. Gleason scoring based on the radical prostatectomy specimen was higher than in both primary reports and re‐evaluation of biopsies. Although a relatively high degree of concordance was found between biopsy assessments, the significant trend towards higher Gleason scoring at re‐evaluation, leading to frequent changes in clinical assessments and surgical strategy, justifies re‐evaluation of PCa biopsies in patients with primary GS ≤ 6.