OBJECTIVES: To determine the agreement between the local pathologist findings and central pathologist findings using data from the TAX 3501 trial. TAX 3501 was a randomized, multinational trial comparing the outcomes of patients with high-risk prostate cancer treated with androgen deprivation with or without docetaxel after radical prostatectomy (RP). Patient eligibility was determined by a minimal 5-year progression-free survival estimate of 60% using Kattan's nomogram. METHODS: The pathologic findings were reassessed in 257 consecutive RP specimens by 2 central pathologists and compared with the local pathologist data. RESULTS: For the Gleason score, agreement was found in 181 (70%) of 257 cases, upgrading in 57 (75%), and downgrading in 25% of the RP specimens The most frequent upgrade was from Gleason score 7 to 8 or 9 and downgrading from Gleason score 8 to 7. Of the upgrades and downgrades, 37% and 21% were of 2 Gleason score points, respectively. For the tumor extent, agreement was found in 179 (70%) of 256 specimens, with upstaging in 70 (91%) and downstaging in 9%. The most frequent upstage was from focal to extensive extraprostatic extension (45%). For seminal vesicle invasion, agreement was found for 238 (93%) of 256 RP specimens Almost equal rates of underdiagnosing and overdiagnosing seminal vesicle invasion was observed. For margin status, agreement was present for 229 (89%) of 256 cases. The central pathologist review led to reclassification as a positive margin in 17 cases and a negative margin in 10. For lymph node status, 2 (1%) of 210 RP specimens had positive nodes identified only by the central pathologist. Agreement was observed in 154 negative and 54 positive cases. CONCLUSIONS: Significant interobserver variations were found between the central and local pathologists. From the central pathologist review, the progression-free survival estimates were altered in 31 patients (13%), including 22 who were reassigned a greater risk estimate, rendering them study eligible. Thus, interobserver variability affected prognostication and trial accrual.
OBJECTIVES: To determine the agreement between the local pathologist findings and central pathologist findings using data from the TAX 3501 trial. TAX 3501 was a randomized, multinational trial comparing the outcomes of patients with high-risk prostate cancer treated with androgen deprivation with or without docetaxel after radical prostatectomy (RP). Patient eligibility was determined by a minimal 5-year progression-free survival estimate of 60% using Kattan's nomogram. METHODS: The pathologic findings were reassessed in 257 consecutive RP specimens by 2 central pathologists and compared with the local pathologist data. RESULTS: For the Gleason score, agreement was found in 181 (70%) of 257 cases, upgrading in 57 (75%), and downgrading in 25% of the RP specimens The most frequent upgrade was from Gleason score 7 to 8 or 9 and downgrading from Gleason score 8 to 7. Of the upgrades and downgrades, 37% and 21% were of 2 Gleason score points, respectively. For the tumor extent, agreement was found in 179 (70%) of 256 specimens, with upstaging in 70 (91%) and downstaging in 9%. The most frequent upstage was from focal to extensive extraprostatic extension (45%). For seminal vesicle invasion, agreement was found for 238 (93%) of 256 RP specimens Almost equal rates of underdiagnosing and overdiagnosing seminal vesicle invasion was observed. For margin status, agreement was present for 229 (89%) of 256 cases. The central pathologist review led to reclassification as a positive margin in 17 cases and a negative margin in 10. For lymph node status, 2 (1%) of 210 RP specimens had positive nodes identified only by the central pathologist. Agreement was observed in 154 negative and 54 positive cases. CONCLUSIONS: Significant interobserver variations were found between the central and local pathologists. From the central pathologist review, the progression-free survival estimates were altered in 31 patients (13%), including 22 who were reassigned a greater risk estimate, rendering them study eligible. Thus, interobserver variability affected prognostication and trial accrual.
Authors: Jonathan I Epstein; Mahul Amin; Liliane Boccon-Gibod; Lars Egevad; Peter A Humphrey; Gregor Mikuz; Don Newling; Sten Nilsson; Wael Sakr; John R Srigley; Thomas M Wheeler; Rodolfo Montironi Journal: Scand J Urol Nephrol Suppl Date: 2005-05
Authors: Theodorus H van der Kwast; Laurence Collette; Hein Van Poppel; Paul Van Cangh; Kris Vekemans; Luigi DaPozzo; Jean-François Bosset; Karl H Kurth; Fritz H Schröder; Michel Bolla Journal: Virchows Arch Date: 2006-08-29 Impact factor: 4.064
Authors: M Burchardt; R Engers; M Müller; T Burchardt; R Willers; J I Epstein; R Ackermann; H E Gabbert; A de la Taille; M A Rubin Journal: J Cancer Res Clin Oncol Date: 2008-04-08 Impact factor: 4.553
Authors: Attila Majoros; Attila Marcell Szász; Péter Nyirády; Eszter Székely; Péter Riesz; Attila Szendrői; Attila Keszthelyi; Janina Kulka; Imre Romics Journal: Int Urol Nephrol Date: 2013-08-30 Impact factor: 2.370
Authors: Luis F R Taveira; Tahsin Kurc; Alba C M A Melo; Jun Kong; Erich Bremer; Joel H Saltz; George Teodoro Journal: J Digit Imaging Date: 2019-06 Impact factor: 4.056
Authors: Tuomas Mirtti; Benjamin E Leiby; Junaid Abdulghani; Elina Aaltonen; Miia Pavela; Anita Mamtani; Kalle Alanen; Lars Egevad; Torvald Granfors; Andreas Josefsson; Par Stattin; Anders Bergh; Marja T Nevalainen Journal: Hum Pathol Date: 2012-09-29 Impact factor: 3.466
Authors: Alcides Chaux; Daniel A Fajardo; Nilda Gonzalez-Roibon; Alan W Partin; Mario Eisenberger; Theodore L DeWeese; George J Netto Journal: Urology Date: 2011-12-14 Impact factor: 2.649
Authors: Jacob E Tallman; Vignesh T Packiam; Kristen E Wroblewski; Gladell P Paner; Scott E Eggener Journal: Urol Oncol Date: 2017-03-13 Impact factor: 3.498
Authors: Emmanuel S Antonarakis; Daniel Keizman; Zhe Zhang; Bora Gurel; Tamara L Lotan; Jessica L Hicks; Helen L Fedor; Michael A Carducci; Angelo M De Marzo; Mario A Eisenberger Journal: Cancer Date: 2012-06-06 Impact factor: 6.860
Authors: Natasha C Townsend; Karen Ruth; Tahseen Al-Saleem; Eric M Horwitz; Mark Sobczak; Robert G Uzzo; Rosalia Viterbo; Mark K Buyyounouski Journal: J Natl Compr Canc Netw Date: 2013-07 Impact factor: 11.908