Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution
In prostate cancer, accurate diagnosis and grade group (GG) decision based on biopsy findings are essential for determining treatment strategies. Diagnosis by experienced urological pathologists is recommended; however, their contribution to patient benefits remains unknown. Therefore, we analyzed c...
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| Veröffentlicht in: | Virchows Archiv : an international journal of pathology 2022-05, Vol.480 (5), p.979-987 |
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| creator | Okubo, Yoichiro Yamamoto, Yayoi Sato, Shinya Yoshioka, Emi Suzuki, Masaki Washimi, Kota Osaka, Kimito Suzuki, Takahisa Yokose, Tomoyuki Kishida, Takeshi Miyagi, Yohei |
| description | In prostate cancer, accurate diagnosis and grade group (GG) decision based on biopsy findings are essential for determining treatment strategies. Diagnosis by experienced urological pathologists is recommended; however, their contribution to patient benefits remains unknown. Therefore, we analyzed clinicopathological information to determine the significance of reassessment by experienced urological pathologists at a high-volume institution to identify factors involved in the agreement or disagreement of biopsy and surgical GGs. In total, 1325 prostate adenocarcinomas were analyzed, and the GG was changed in 452/1325 (34.1%) cases (359 cases were upgraded, and 93 cases were downgraded). We compared the highest GG based on biopsy specimens, with the final GG based on surgical specimens of 210 cases. The agreement rate between the surgical GG performed and assessed in our institute and the highest biopsy GG assessed by an outside pathologist was 34.8% (73/210); the agreement rate increased significantly to 50% (105/210) when biopsy specimens were reevaluated in our institute (chi-square test,
P
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| doi_str_mv | 10.1007/s00428-022-03272-0 |
| format | Article |
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P
< 0.01). Multivariate logistic regression analysis showed that only the length of the lesion in the positive core with the highest GG in the biopsy was a significant factor for determining the agreement between biopsy GG and surgical GG, with an odds ratio of 1.136 (95% confidence interval: 1.057–1.221;
P
< 0.01). Thus, reassessment by experienced urological pathologists at high-volume institutions improved the agreement rate. However, it should be noted there is a high probability of discordance between a small number of lesions or short lesions and surgical GG.</description><identifier>ISSN: 0945-6317</identifier><identifier>EISSN: 1432-2307</identifier><identifier>DOI: 10.1007/s00428-022-03272-0</identifier><identifier>PMID: 35015130</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Agreements ; Biopsy ; Chi-square test ; Confidence intervals ; Diagnosis ; Discordance ; Humans ; Lesions ; Male ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Neoplasm Grading ; Original ; Original Article ; Pathologists ; Pathology ; Prostate ; Prostate - pathology ; Prostate cancer ; Prostatectomy ; Prostatic Neoplasms - pathology ; Regression analysis ; Statistical analysis ; Statistical tests</subject><ispartof>Virchows Archiv : an international journal of pathology, 2022-05, Vol.480 (5), p.979-987</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://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-c540t-d5f6256c5fe1cd5acd9c29cd2f39f5a12676da802b30af11f4c115563c60fab63</citedby><cites>FETCH-LOGICAL-c540t-d5f6256c5fe1cd5acd9c29cd2f39f5a12676da802b30af11f4c115563c60fab63</cites><orcidid>0000-0002-7079-4454</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00428-022-03272-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00428-022-03272-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35015130$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okubo, Yoichiro</creatorcontrib><creatorcontrib>Yamamoto, Yayoi</creatorcontrib><creatorcontrib>Sato, Shinya</creatorcontrib><creatorcontrib>Yoshioka, Emi</creatorcontrib><creatorcontrib>Suzuki, Masaki</creatorcontrib><creatorcontrib>Washimi, Kota</creatorcontrib><creatorcontrib>Osaka, Kimito</creatorcontrib><creatorcontrib>Suzuki, Takahisa</creatorcontrib><creatorcontrib>Yokose, Tomoyuki</creatorcontrib><creatorcontrib>Kishida, Takeshi</creatorcontrib><creatorcontrib>Miyagi, Yohei</creatorcontrib><title>Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution</title><title>Virchows Archiv : an international journal of pathology</title><addtitle>Virchows Arch</addtitle><addtitle>Virchows Arch</addtitle><description>In prostate cancer, accurate diagnosis and grade group (GG) decision based on biopsy findings are essential for determining treatment strategies. Diagnosis by experienced urological pathologists is recommended; however, their contribution to patient benefits remains unknown. Therefore, we analyzed clinicopathological information to determine the significance of reassessment by experienced urological pathologists at a high-volume institution to identify factors involved in the agreement or disagreement of biopsy and surgical GGs. In total, 1325 prostate adenocarcinomas were analyzed, and the GG was changed in 452/1325 (34.1%) cases (359 cases were upgraded, and 93 cases were downgraded). We compared the highest GG based on biopsy specimens, with the final GG based on surgical specimens of 210 cases. The agreement rate between the surgical GG performed and assessed in our institute and the highest biopsy GG assessed by an outside pathologist was 34.8% (73/210); the agreement rate increased significantly to 50% (105/210) when biopsy specimens were reevaluated in our institute (chi-square test,
P
< 0.01). Multivariate logistic regression analysis showed that only the length of the lesion in the positive core with the highest GG in the biopsy was a significant factor for determining the agreement between biopsy GG and surgical GG, with an odds ratio of 1.136 (95% confidence interval: 1.057–1.221;
P
< 0.01). Thus, reassessment by experienced urological pathologists at high-volume institutions improved the agreement rate. However, it should be noted there is a high probability of discordance between a small number of lesions or short lesions and surgical GG.</description><subject>Agreements</subject><subject>Biopsy</subject><subject>Chi-square test</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Discordance</subject><subject>Humans</subject><subject>Lesions</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Grading</subject><subject>Original</subject><subject>Original Article</subject><subject>Pathologists</subject><subject>Pathology</subject><subject>Prostate</subject><subject>Prostate - pathology</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Regression analysis</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><issn>0945-6317</issn><issn>1432-2307</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc2OFCEUhYnROO3oC7gwJG7clHKhoLo2Jmb8TSZxo2tCUVDNpBpKLjWx38DHlp4ex5-FG8jN-e65XA4hT4G9BMa6V8hYy7cN47xhgnf1vEc20ArecMG6-2TD-lY2SkB3Rh4hXjHGYQvqITkTkoEEwTbkx9tgppiwBEsxTDH4YE20jiZPszOIDnHvYjnWS66cKY4OIS14oLg4G6qIdDhQ931xObjaOtI1pzlN1Wimiym7mwILUlOoobsw7ZrrNK97R0Osg8taQoqPyQNvZnRPbu9z8vX9uy8XH5vLzx8-Xby5bKxsWWlG6RWXykrvwI7S2LG3vLcj96L30gBXnRrNlvFBMOMBfGsBpFTCKubNoMQ5eX3yXdZh70Zbd8tm1ksOe5MPOpmg_1Zi2OkpXeueCdEBVIMXtwY5fVsdFr0PaN08m-jSipor2PYg-1ZU9Pk_6FVac6zrVUqKFoRSrFL8RNn6v5idv3sMMH0MWp-C1jVofRO0PjY9-3ONu5ZfyVZAnACsUpxc_j37P7Y_AaVFuFs</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Okubo, Yoichiro</creator><creator>Yamamoto, Yayoi</creator><creator>Sato, Shinya</creator><creator>Yoshioka, Emi</creator><creator>Suzuki, Masaki</creator><creator>Washimi, Kota</creator><creator>Osaka, Kimito</creator><creator>Suzuki, Takahisa</creator><creator>Yokose, Tomoyuki</creator><creator>Kishida, Takeshi</creator><creator>Miyagi, Yohei</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><orcidid>https://orcid.org/0000-0002-7079-4454</orcidid></search><sort><creationdate>20220501</creationdate><title>Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution</title><author>Okubo, Yoichiro ; Yamamoto, Yayoi ; Sato, Shinya ; Yoshioka, Emi ; Suzuki, Masaki ; Washimi, Kota ; Osaka, Kimito ; Suzuki, Takahisa ; Yokose, Tomoyuki ; Kishida, Takeshi ; Miyagi, Yohei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-d5f6256c5fe1cd5acd9c29cd2f39f5a12676da802b30af11f4c115563c60fab63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Agreements</topic><topic>Biopsy</topic><topic>Chi-square test</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>Discordance</topic><topic>Humans</topic><topic>Lesions</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Grading</topic><topic>Original</topic><topic>Original Article</topic><topic>Pathologists</topic><topic>Pathology</topic><topic>Prostate</topic><topic>Prostate - 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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>Okubo, Yoichiro</au><au>Yamamoto, Yayoi</au><au>Sato, Shinya</au><au>Yoshioka, Emi</au><au>Suzuki, Masaki</au><au>Washimi, Kota</au><au>Osaka, Kimito</au><au>Suzuki, Takahisa</au><au>Yokose, Tomoyuki</au><au>Kishida, Takeshi</au><au>Miyagi, Yohei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution</atitle><jtitle>Virchows Archiv : an international journal of pathology</jtitle><stitle>Virchows Arch</stitle><addtitle>Virchows Arch</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>480</volume><issue>5</issue><spage>979</spage><epage>987</epage><pages>979-987</pages><issn>0945-6317</issn><eissn>1432-2307</eissn><abstract>In prostate cancer, accurate diagnosis and grade group (GG) decision based on biopsy findings are essential for determining treatment strategies. Diagnosis by experienced urological pathologists is recommended; however, their contribution to patient benefits remains unknown. Therefore, we analyzed clinicopathological information to determine the significance of reassessment by experienced urological pathologists at a high-volume institution to identify factors involved in the agreement or disagreement of biopsy and surgical GGs. In total, 1325 prostate adenocarcinomas were analyzed, and the GG was changed in 452/1325 (34.1%) cases (359 cases were upgraded, and 93 cases were downgraded). We compared the highest GG based on biopsy specimens, with the final GG based on surgical specimens of 210 cases. The agreement rate between the surgical GG performed and assessed in our institute and the highest biopsy GG assessed by an outside pathologist was 34.8% (73/210); the agreement rate increased significantly to 50% (105/210) when biopsy specimens were reevaluated in our institute (chi-square test,
P
< 0.01). Multivariate logistic regression analysis showed that only the length of the lesion in the positive core with the highest GG in the biopsy was a significant factor for determining the agreement between biopsy GG and surgical GG, with an odds ratio of 1.136 (95% confidence interval: 1.057–1.221;
P
< 0.01). Thus, reassessment by experienced urological pathologists at high-volume institutions improved the agreement rate. However, it should be noted there is a high probability of discordance between a small number of lesions or short lesions and surgical GG.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35015130</pmid><doi>10.1007/s00428-022-03272-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7079-4454</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Agreements Biopsy Chi-square test Confidence intervals Diagnosis Discordance Humans Lesions Male Medical diagnosis Medicine Medicine & Public Health Neoplasm Grading Original Original Article Pathologists Pathology Prostate Prostate - pathology Prostate cancer Prostatectomy Prostatic Neoplasms - pathology Regression analysis Statistical analysis Statistical tests |
| title | Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution |
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