Repeated biopsies in patients with prostate cancer on active surveillance: clinical implications of interobserver variation in histopathological assessment

Frederik B Thomsen, Niels Marcussen, Kasper D Berg, Ib J Christensen, Ben Vainer, Peter Iversen, Klaus Brasso

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: To investigate the clinical implications of interobserver variation in the assessment of re-biopsies obtained during active surveillance (AS) of prostate cancer.

PATIENTS AND METHODS: In all, 107 patients with low-risk prostate cancer with 93 diagnostic biopsy sets and 109 re-biopsy sets were included. The International Society of Urological Pathology 2005 Gleason scoring system was used for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa (κ) statistics were used to compare the interobserver agreement.

RESULTS: The overall Gleason score agreement was 68.8% with a weighted κ of 0.670. The interobserver agreement was 79.6% for meeting the AS selection criteria. According to the three progression definitions applied, overall agreement was between 80.7% and 89.0% with weighted κ values of 0.746-0.791. Treatment recommendations would have changed in up to 10.1% (95% confidence interval 5.4-17.7%) of the 109 re-biopsy sets.

CONCLUSION: Kappa statistics showed strong agreement between the histological evaluations. However, up to 10% of patients on AS would receive a different treatment recommendation depending upon which histopathological evaluation of re-biopsies was used for treatment planning.

OriginalsprogEngelsk
TidsskriftB J U International (Print)
Vol/bind115
Udgave nummer4
Sider (fra-til)599–605
ISSN1464-4096
DOI
StatusUdgivet - 2015

Fingeraftryk

Observer Variation
Prostatic Neoplasms
Neoplasm Grading
Patient Selection
Confidence Intervals
Pathology

Bibliografisk note

Article first published online: 16 AUG 2014

Citer dette

Thomsen, Frederik B ; Marcussen, Niels ; Berg, Kasper D ; Christensen, Ib J ; Vainer, Ben ; Iversen, Peter ; Brasso, Klaus. / Repeated biopsies in patients with prostate cancer on active surveillance : clinical implications of interobserver variation in histopathological assessment. I: B J U International (Print). 2015 ; Bind 115, Nr. 4. s. 599–605.
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title = "Repeated biopsies in patients with prostate cancer on active surveillance: clinical implications of interobserver variation in histopathological assessment",
abstract = "OBJECTIVE: To investigate the clinical implications of interobserver variation in the assessment of re-biopsies obtained during active surveillance (AS) of prostate cancer.PATIENTS AND METHODS: In all, 107 patients with low-risk prostate cancer with 93 diagnostic biopsy sets and 109 re-biopsy sets were included. The International Society of Urological Pathology 2005 Gleason scoring system was used for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa (κ) statistics were used to compare the interobserver agreement.RESULTS: The overall Gleason score agreement was 68.8{\%} with a weighted κ of 0.670. The interobserver agreement was 79.6{\%} for meeting the AS selection criteria. According to the three progression definitions applied, overall agreement was between 80.7{\%} and 89.0{\%} with weighted κ values of 0.746-0.791. Treatment recommendations would have changed in up to 10.1{\%} (95{\%} confidence interval 5.4-17.7{\%}) of the 109 re-biopsy sets.CONCLUSION: Kappa statistics showed strong agreement between the histological evaluations. However, up to 10{\%} of patients on AS would receive a different treatment recommendation depending upon which histopathological evaluation of re-biopsies was used for treatment planning.",
author = "Thomsen, {Frederik B} and Niels Marcussen and Berg, {Kasper D} and Christensen, {Ib J} and Ben Vainer and Peter Iversen and Klaus Brasso",
note = "Article first published online: 16 AUG 2014",
year = "2015",
doi = "10.1111/bju.12820",
language = "English",
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pages = "599–605",
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Repeated biopsies in patients with prostate cancer on active surveillance : clinical implications of interobserver variation in histopathological assessment. / Thomsen, Frederik B; Marcussen, Niels; Berg, Kasper D; Christensen, Ib J; Vainer, Ben; Iversen, Peter; Brasso, Klaus.

I: B J U International (Print), Bind 115, Nr. 4, 2015, s. 599–605.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Repeated biopsies in patients with prostate cancer on active surveillance

T2 - clinical implications of interobserver variation in histopathological assessment

AU - Thomsen, Frederik B

AU - Marcussen, Niels

AU - Berg, Kasper D

AU - Christensen, Ib J

AU - Vainer, Ben

AU - Iversen, Peter

AU - Brasso, Klaus

N1 - Article first published online: 16 AUG 2014

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: To investigate the clinical implications of interobserver variation in the assessment of re-biopsies obtained during active surveillance (AS) of prostate cancer.PATIENTS AND METHODS: In all, 107 patients with low-risk prostate cancer with 93 diagnostic biopsy sets and 109 re-biopsy sets were included. The International Society of Urological Pathology 2005 Gleason scoring system was used for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa (κ) statistics were used to compare the interobserver agreement.RESULTS: The overall Gleason score agreement was 68.8% with a weighted κ of 0.670. The interobserver agreement was 79.6% for meeting the AS selection criteria. According to the three progression definitions applied, overall agreement was between 80.7% and 89.0% with weighted κ values of 0.746-0.791. Treatment recommendations would have changed in up to 10.1% (95% confidence interval 5.4-17.7%) of the 109 re-biopsy sets.CONCLUSION: Kappa statistics showed strong agreement between the histological evaluations. However, up to 10% of patients on AS would receive a different treatment recommendation depending upon which histopathological evaluation of re-biopsies was used for treatment planning.

AB - OBJECTIVE: To investigate the clinical implications of interobserver variation in the assessment of re-biopsies obtained during active surveillance (AS) of prostate cancer.PATIENTS AND METHODS: In all, 107 patients with low-risk prostate cancer with 93 diagnostic biopsy sets and 109 re-biopsy sets were included. The International Society of Urological Pathology 2005 Gleason scoring system was used for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa (κ) statistics were used to compare the interobserver agreement.RESULTS: The overall Gleason score agreement was 68.8% with a weighted κ of 0.670. The interobserver agreement was 79.6% for meeting the AS selection criteria. According to the three progression definitions applied, overall agreement was between 80.7% and 89.0% with weighted κ values of 0.746-0.791. Treatment recommendations would have changed in up to 10.1% (95% confidence interval 5.4-17.7%) of the 109 re-biopsy sets.CONCLUSION: Kappa statistics showed strong agreement between the histological evaluations. However, up to 10% of patients on AS would receive a different treatment recommendation depending upon which histopathological evaluation of re-biopsies was used for treatment planning.

U2 - 10.1111/bju.12820

DO - 10.1111/bju.12820

M3 - Journal article

C2 - 24903618

VL - 115

SP - 599

EP - 605

JO - B J U International (Print)

JF - B J U International (Print)

SN - 1464-4096

IS - 4

ER -