Interobserver reproducibility of Gleason grading of prostatic adenocarcinoma among general pathologists

Abstract

In our study interobserver reproducibility of Gleason scores among general pathologists was at lower level and it highlights the need to improve the observer reproducibility by continuous educational sessions and taking second opinion in cases where grade could significantly influence management.

Blinded review of archival radical prostatectomy specimens supports that contemporary Gleason score 6 prostate cancer lacks metastatic potential

“…However, before moderation of postoperative surveillance is considered for any pGS6 patient, it may be necessary to confirm the absence of Gleason pattern 4 by RP pathology review. Gleason pattern 4 can be frequently identified among even BF‐free pGS6 patients (38% rate in the current study), which underscores inter‐observer variability in pGS6 grade assignment . At RPCI, we discuss the option of deferring radiation with pGS6 patients who develop BF, if independent RP pathology review in a formal multidisciplinary tumor board confirms the absence of a higher Gleason pattern.…”

“…However, a limitation of these studies is that regrading was performed by a single pathologist who was aware of the metastasis outcomes and study objectives, which introduces potential for upgrading bias. Given the practical subjectivity and inter‐observer variability of Gleason score assignment, these findings require confirmation using an unbiased study design with multiple independent blinded pathologists.…”

“…Given the practical subjectivity and inter-observer variability of Gleason score assignment, 8,[16][17][18][19][20][21] these findings require confirmation using an unbiased study design with multiple independent blinded pathologists.…”

The updated grading system of prostate carcinoma: an inter‐observer agreement study among general pathologists in an academic practice

“…Our result is better than Coard & Freeman's study, which showed 60% concordance rate . Similarly, Singh et al found low level of reproducibility among general pathologists. Besides, Melia et al reported the intra‐observer agreement among uropathologists to be only 77%.…”

The Combination of DNA Ploidy Status and PTEN/6q15 Deletions Provides Strong and Independent Prognostic Information in Prostate Cancer

“…variability (37)(38)(39). That ploidy measurement by itself cannot make Gleason grading "safe" in its capability to identify the "dangerous" cancers is, however, demonstrated by the 39.9% of Gleason !4þ4 cancers (known to have a dismal prognosis), and the 55.2% of cancers with PSA recurrence, having a diploid DNA content.…”