Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer
Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at...
Gespeichert in:
| Veröffentlicht in: | Virchows Archiv : an international journal of pathology 2020-02, Vol.476 (2), p.219-230 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 230 |
|---|---|
| container_issue | 2 |
| container_start_page | 219 |
| container_title | Virchows Archiv : an international journal of pathology |
| container_volume | 476 |
| creator | Klaver, Charlotte E. L. Bulkmans, Nicole Drillenburg, Paul Grabsch, Heike I. van Grieken, Nicole C. T. Karrenbeld, Arend Koens, Lianne van Lijnschoten, Ineke Meijer, Jos Nagtegaal, Iris D. Sagaert, Xavier Seldenrijk, Kees van Velthuysen, M. F. Bruggink, Annette H. Tanis, Pieter J. Snaebjornsson, Petur |
| description | Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at a distance of 25–1500 μm (
n
= 22), 0–25 μm (
n
= 22), or on (
n
= 22) the peritoneal surface.
Inter
- and
intra
observer variability were calculated using Kappa statistics. For
inter
laboratory variability, pathology reports of pT3 and pT4a colon cancer were extracted from the Dutch Pathology Registry between 2012 and 2015. The proportion of pT4a (pT4a/(pT3+pT4a)) was compared between 33 laboratories. Potential risk of understaging was assessed by determining the average number of blocks taken from pT3 and pT4a N0-2M0 tumors with metachronous peritoneal metastasis.
Inter
observer variability among 12 pathologists was 0.50 (95%CI 0.41–0.60; moderate agreement).
Intra
observer variability (8 pathologists) was 0.71 (substantial agreement). A total of 7745 reports with pT3 or pT4aN0-2M0 colon cancer from 33 laboratories were included for
inter
laboratory analysis. Median percentage of pT4a was 15.5% (range 3.2–24.6%). After adjustment for case mix, 8 labs diagnosed pT4a significantly less or more frequently than the median lab. Metachronous peritoneal metastases were histologically verified in 170 of 6629 pT3 and in 129 of 1116 pT4a tumors, with a mean number of blocks of 4.03(SD 1.51) and 4.78 (SD 1.76) taken from the primary tumors, respectively (
p
|
| doi_str_mv | 10.1007/s00428-019-02663-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7028812</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2306215471</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-db5a0f75ac4145d7c3a802573a7698ed015f4cf34a4094f0d81047e4e9548e9a3</originalsourceid><addsrcrecordid>eNp9kU2LFDEQhoMo7rj6BzxIgxcPtlblo5O-CLL4sbDgZb0JoTqdHrP0JGPSMzD_3oyz7qoHTyGpp96qNy9jzxHeIIB-WwAkNy1g3wLvOtHCA7ZCKXjLBeiHbAW9VG0nUJ-xJ6XcAHA02D1mZwI77HqDK_btMi4-p6H4vPf5dRPikun-SnE8Pvk805AyLSkfmj3lQEOYw3KotSb7bcpLiOtmey2pcWlOsXEUnc9P2aOJ5uKf3Z7n7OvHD9cXn9urL58uL95ftU5qubTjoAgmrchJlGrUTpABrrQgXZf0I6CapJuEJFkdTTAaBKm99L2Sxvckztm7k-52N2z86PzRxGy3OWwoH2yiYP-uxPDdrtPeauDGIK8Cr24Fcvqx82Wxm1Ccn2eKPu2Krf_ZcVRSY0Vf_oPepF2O1V6lVGdQg1GV4ifK5VRK9tPdMgj2GJ49hWdrePZXeBZq04s_bdy1_E6rAuIElFqKa5_vZ_9H9icsqqZE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2356817085</pqid></control><display><type>article</type><title>Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Klaver, Charlotte E. L. ; Bulkmans, Nicole ; Drillenburg, Paul ; Grabsch, Heike I. ; van Grieken, Nicole C. T. ; Karrenbeld, Arend ; Koens, Lianne ; van Lijnschoten, Ineke ; Meijer, Jos ; Nagtegaal, Iris D. ; Sagaert, Xavier ; Seldenrijk, Kees ; van Velthuysen, M. F. ; Bruggink, Annette H. ; Tanis, Pieter J. ; Snaebjornsson, Petur</creator><creatorcontrib>Klaver, Charlotte E. L. ; Bulkmans, Nicole ; Drillenburg, Paul ; Grabsch, Heike I. ; van Grieken, Nicole C. T. ; Karrenbeld, Arend ; Koens, Lianne ; van Lijnschoten, Ineke ; Meijer, Jos ; Nagtegaal, Iris D. ; Sagaert, Xavier ; Seldenrijk, Kees ; van Velthuysen, M. F. ; Bruggink, Annette H. ; Tanis, Pieter J. ; Snaebjornsson, Petur</creatorcontrib><description>Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at a distance of 25–1500 μm (
n
= 22), 0–25 μm (
n
= 22), or on (
n
= 22) the peritoneal surface.
Inter
- and
intra
observer variability were calculated using Kappa statistics. For
inter
laboratory variability, pathology reports of pT3 and pT4a colon cancer were extracted from the Dutch Pathology Registry between 2012 and 2015. The proportion of pT4a (pT4a/(pT3+pT4a)) was compared between 33 laboratories. Potential risk of understaging was assessed by determining the average number of blocks taken from pT3 and pT4a N0-2M0 tumors with metachronous peritoneal metastasis.
Inter
observer variability among 12 pathologists was 0.50 (95%CI 0.41–0.60; moderate agreement).
Intra
observer variability (8 pathologists) was 0.71 (substantial agreement). A total of 7745 reports with pT3 or pT4aN0-2M0 colon cancer from 33 laboratories were included for
inter
laboratory analysis. Median percentage of pT4a was 15.5% (range 3.2–24.6%). After adjustment for case mix, 8 labs diagnosed pT4a significantly less or more frequently than the median lab. Metachronous peritoneal metastases were histologically verified in 170 of 6629 pT3 and in 129 of 1116 pT4a tumors, with a mean number of blocks of 4.03(SD 1.51) and 4.78 (SD 1.76) taken from the primary tumors, respectively (
p
< 0.001). A substantial variability in diagnosing pT4a colon cancer exists, both at pathologist and laboratory level. Diagnosis of pT4a stage appears to be challenging and there is a need for standardizing assessment of this pathological entity.</description><identifier>ISSN: 0945-6317</identifier><identifier>EISSN: 1432-2307</identifier><identifier>DOI: 10.1007/s00428-019-02663-0</identifier><identifier>PMID: 31616981</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adenocarcinoma - diagnosis ; Adenocarcinoma - pathology ; Colon ; Colon cancer ; Colonic Neoplasms - diagnosis ; Colonic Neoplasms - pathology ; Colorectal cancer ; Gastric cancer ; Humans ; Laboratories ; Lymphatic Metastasis - pathology ; Median (statistics) ; Medicine ; Medicine & Public Health ; Metastases ; Neoplasm Invasiveness - pathology ; Observer Variation ; Original ; Original Article ; Pathology ; Peritoneum ; Peritoneum - pathology ; Prognosis ; Quality in Pathology ; Retrospective Studies ; Statistical analysis ; Tumor cells ; Tumors ; Variability</subject><ispartof>Virchows Archiv : an international journal of pathology, 2020-02, Vol.476 (2), p.219-230</ispartof><rights>The Author(s) 2019</rights><rights>Virchows Archiv is a copyright of Springer, (2019). All Rights Reserved. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-db5a0f75ac4145d7c3a802573a7698ed015f4cf34a4094f0d81047e4e9548e9a3</citedby><cites>FETCH-LOGICAL-c474t-db5a0f75ac4145d7c3a802573a7698ed015f4cf34a4094f0d81047e4e9548e9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00428-019-02663-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00428-019-02663-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31616981$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klaver, Charlotte E. L.</creatorcontrib><creatorcontrib>Bulkmans, Nicole</creatorcontrib><creatorcontrib>Drillenburg, Paul</creatorcontrib><creatorcontrib>Grabsch, Heike I.</creatorcontrib><creatorcontrib>van Grieken, Nicole C. T.</creatorcontrib><creatorcontrib>Karrenbeld, Arend</creatorcontrib><creatorcontrib>Koens, Lianne</creatorcontrib><creatorcontrib>van Lijnschoten, Ineke</creatorcontrib><creatorcontrib>Meijer, Jos</creatorcontrib><creatorcontrib>Nagtegaal, Iris D.</creatorcontrib><creatorcontrib>Sagaert, Xavier</creatorcontrib><creatorcontrib>Seldenrijk, Kees</creatorcontrib><creatorcontrib>van Velthuysen, M. F.</creatorcontrib><creatorcontrib>Bruggink, Annette H.</creatorcontrib><creatorcontrib>Tanis, Pieter J.</creatorcontrib><creatorcontrib>Snaebjornsson, Petur</creatorcontrib><title>Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer</title><title>Virchows Archiv : an international journal of pathology</title><addtitle>Virchows Arch</addtitle><addtitle>Virchows Arch</addtitle><description>Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at a distance of 25–1500 μm (
n
= 22), 0–25 μm (
n
= 22), or on (
n
= 22) the peritoneal surface.
Inter
- and
intra
observer variability were calculated using Kappa statistics. For
inter
laboratory variability, pathology reports of pT3 and pT4a colon cancer were extracted from the Dutch Pathology Registry between 2012 and 2015. The proportion of pT4a (pT4a/(pT3+pT4a)) was compared between 33 laboratories. Potential risk of understaging was assessed by determining the average number of blocks taken from pT3 and pT4a N0-2M0 tumors with metachronous peritoneal metastasis.
Inter
observer variability among 12 pathologists was 0.50 (95%CI 0.41–0.60; moderate agreement).
Intra
observer variability (8 pathologists) was 0.71 (substantial agreement). A total of 7745 reports with pT3 or pT4aN0-2M0 colon cancer from 33 laboratories were included for
inter
laboratory analysis. Median percentage of pT4a was 15.5% (range 3.2–24.6%). After adjustment for case mix, 8 labs diagnosed pT4a significantly less or more frequently than the median lab. Metachronous peritoneal metastases were histologically verified in 170 of 6629 pT3 and in 129 of 1116 pT4a tumors, with a mean number of blocks of 4.03(SD 1.51) and 4.78 (SD 1.76) taken from the primary tumors, respectively (
p
< 0.001). A substantial variability in diagnosing pT4a colon cancer exists, both at pathologist and laboratory level. Diagnosis of pT4a stage appears to be challenging and there is a need for standardizing assessment of this pathological entity.</description><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - pathology</subject><subject>Colon</subject><subject>Colon cancer</subject><subject>Colonic Neoplasms - diagnosis</subject><subject>Colonic Neoplasms - pathology</subject><subject>Colorectal cancer</subject><subject>Gastric cancer</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Median (statistics)</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Observer Variation</subject><subject>Original</subject><subject>Original Article</subject><subject>Pathology</subject><subject>Peritoneum</subject><subject>Peritoneum - pathology</subject><subject>Prognosis</subject><subject>Quality in Pathology</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Tumor cells</subject><subject>Tumors</subject><subject>Variability</subject><issn>0945-6317</issn><issn>1432-2307</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU2LFDEQhoMo7rj6BzxIgxcPtlblo5O-CLL4sbDgZb0JoTqdHrP0JGPSMzD_3oyz7qoHTyGpp96qNy9jzxHeIIB-WwAkNy1g3wLvOtHCA7ZCKXjLBeiHbAW9VG0nUJ-xJ6XcAHA02D1mZwI77HqDK_btMi4-p6H4vPf5dRPikun-SnE8Pvk805AyLSkfmj3lQEOYw3KotSb7bcpLiOtmey2pcWlOsXEUnc9P2aOJ5uKf3Z7n7OvHD9cXn9urL58uL95ftU5qubTjoAgmrchJlGrUTpABrrQgXZf0I6CapJuEJFkdTTAaBKm99L2Sxvckztm7k-52N2z86PzRxGy3OWwoH2yiYP-uxPDdrtPeauDGIK8Cr24Fcvqx82Wxm1Ccn2eKPu2Krf_ZcVRSY0Vf_oPepF2O1V6lVGdQg1GV4ifK5VRK9tPdMgj2GJ49hWdrePZXeBZq04s_bdy1_E6rAuIElFqKa5_vZ_9H9icsqqZE</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Klaver, Charlotte E. L.</creator><creator>Bulkmans, Nicole</creator><creator>Drillenburg, Paul</creator><creator>Grabsch, Heike I.</creator><creator>van Grieken, Nicole C. T.</creator><creator>Karrenbeld, Arend</creator><creator>Koens, Lianne</creator><creator>van Lijnschoten, Ineke</creator><creator>Meijer, Jos</creator><creator>Nagtegaal, Iris D.</creator><creator>Sagaert, Xavier</creator><creator>Seldenrijk, Kees</creator><creator>van Velthuysen, M. F.</creator><creator>Bruggink, Annette H.</creator><creator>Tanis, Pieter J.</creator><creator>Snaebjornsson, Petur</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7TO</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200201</creationdate><title>Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer</title><author>Klaver, Charlotte E. L. ; Bulkmans, Nicole ; Drillenburg, Paul ; Grabsch, Heike I. ; van Grieken, Nicole C. T. ; Karrenbeld, Arend ; Koens, Lianne ; van Lijnschoten, Ineke ; Meijer, Jos ; Nagtegaal, Iris D. ; Sagaert, Xavier ; Seldenrijk, Kees ; van Velthuysen, M. F. ; Bruggink, Annette H. ; Tanis, Pieter J. ; Snaebjornsson, Petur</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-db5a0f75ac4145d7c3a802573a7698ed015f4cf34a4094f0d81047e4e9548e9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - pathology</topic><topic>Colon</topic><topic>Colon cancer</topic><topic>Colonic Neoplasms - diagnosis</topic><topic>Colonic Neoplasms - pathology</topic><topic>Colorectal cancer</topic><topic>Gastric cancer</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Median (statistics)</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Observer Variation</topic><topic>Original</topic><topic>Original Article</topic><topic>Pathology</topic><topic>Peritoneum</topic><topic>Peritoneum - pathology</topic><topic>Prognosis</topic><topic>Quality in Pathology</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Tumor cells</topic><topic>Tumors</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klaver, Charlotte E. L.</creatorcontrib><creatorcontrib>Bulkmans, Nicole</creatorcontrib><creatorcontrib>Drillenburg, Paul</creatorcontrib><creatorcontrib>Grabsch, Heike I.</creatorcontrib><creatorcontrib>van Grieken, Nicole C. T.</creatorcontrib><creatorcontrib>Karrenbeld, Arend</creatorcontrib><creatorcontrib>Koens, Lianne</creatorcontrib><creatorcontrib>van Lijnschoten, Ineke</creatorcontrib><creatorcontrib>Meijer, Jos</creatorcontrib><creatorcontrib>Nagtegaal, Iris D.</creatorcontrib><creatorcontrib>Sagaert, Xavier</creatorcontrib><creatorcontrib>Seldenrijk, Kees</creatorcontrib><creatorcontrib>van Velthuysen, M. F.</creatorcontrib><creatorcontrib>Bruggink, Annette H.</creatorcontrib><creatorcontrib>Tanis, Pieter J.</creatorcontrib><creatorcontrib>Snaebjornsson, Petur</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Virchows Archiv : an international journal of pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klaver, Charlotte E. L.</au><au>Bulkmans, Nicole</au><au>Drillenburg, Paul</au><au>Grabsch, Heike I.</au><au>van Grieken, Nicole C. T.</au><au>Karrenbeld, Arend</au><au>Koens, Lianne</au><au>van Lijnschoten, Ineke</au><au>Meijer, Jos</au><au>Nagtegaal, Iris D.</au><au>Sagaert, Xavier</au><au>Seldenrijk, Kees</au><au>van Velthuysen, M. F.</au><au>Bruggink, Annette H.</au><au>Tanis, Pieter J.</au><au>Snaebjornsson, Petur</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer</atitle><jtitle>Virchows Archiv : an international journal of pathology</jtitle><stitle>Virchows Arch</stitle><addtitle>Virchows Arch</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>476</volume><issue>2</issue><spage>219</spage><epage>230</epage><pages>219-230</pages><issn>0945-6317</issn><eissn>1432-2307</eissn><abstract>Clinical significance of the pT4 category in colon cancer is increasing with several therapeutic implications. The aim of this study was to evaluate variability in diagnosing pT4a colon cancer. Twelve pathologists classified 66 preselected scanned Hematoxylin/Eosin-stained slides with tumor cells at a distance of 25–1500 μm (
n
= 22), 0–25 μm (
n
= 22), or on (
n
= 22) the peritoneal surface.
Inter
- and
intra
observer variability were calculated using Kappa statistics. For
inter
laboratory variability, pathology reports of pT3 and pT4a colon cancer were extracted from the Dutch Pathology Registry between 2012 and 2015. The proportion of pT4a (pT4a/(pT3+pT4a)) was compared between 33 laboratories. Potential risk of understaging was assessed by determining the average number of blocks taken from pT3 and pT4a N0-2M0 tumors with metachronous peritoneal metastasis.
Inter
observer variability among 12 pathologists was 0.50 (95%CI 0.41–0.60; moderate agreement).
Intra
observer variability (8 pathologists) was 0.71 (substantial agreement). A total of 7745 reports with pT3 or pT4aN0-2M0 colon cancer from 33 laboratories were included for
inter
laboratory analysis. Median percentage of pT4a was 15.5% (range 3.2–24.6%). After adjustment for case mix, 8 labs diagnosed pT4a significantly less or more frequently than the median lab. Metachronous peritoneal metastases were histologically verified in 170 of 6629 pT3 and in 129 of 1116 pT4a tumors, with a mean number of blocks of 4.03(SD 1.51) and 4.78 (SD 1.76) taken from the primary tumors, respectively (
p
< 0.001). A substantial variability in diagnosing pT4a colon cancer exists, both at pathologist and laboratory level. Diagnosis of pT4a stage appears to be challenging and there is a need for standardizing assessment of this pathological entity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31616981</pmid><doi>10.1007/s00428-019-02663-0</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0945-6317 |
| ispartof | Virchows Archiv : an international journal of pathology, 2020-02, Vol.476 (2), p.219-230 |
| issn | 0945-6317 1432-2307 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7028812 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adenocarcinoma - diagnosis Adenocarcinoma - pathology Colon Colon cancer Colonic Neoplasms - diagnosis Colonic Neoplasms - pathology Colorectal cancer Gastric cancer Humans Laboratories Lymphatic Metastasis - pathology Median (statistics) Medicine Medicine & Public Health Metastases Neoplasm Invasiveness - pathology Observer Variation Original Original Article Pathology Peritoneum Peritoneum - pathology Prognosis Quality in Pathology Retrospective Studies Statistical analysis Tumor cells Tumors Variability |
| title | Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T15%3A44%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Interobserver,%20intraobserver,%20and%20interlaboratory%20variability%20in%20reporting%20pT4a%20colon%20cancer&rft.jtitle=Virchows%20Archiv%20:%20an%20international%20journal%20of%20pathology&rft.au=Klaver,%20Charlotte%20E.%20L.&rft.date=2020-02-01&rft.volume=476&rft.issue=2&rft.spage=219&rft.epage=230&rft.pages=219-230&rft.issn=0945-6317&rft.eissn=1432-2307&rft_id=info:doi/10.1007/s00428-019-02663-0&rft_dat=%3Cproquest_pubme%3E2306215471%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2356817085&rft_id=info:pmid/31616981&rfr_iscdi=true |