Titre
Importance and outcome relevance of central pathology review in prostatectomy specimens: data from the SAKK 09/10 randomized trial on prostate cancer.
Type
article
Institution
Externe
Périodique
Auteur(s)
Ghadjar, P.
Auteure/Auteur
Hayoz, S.
Auteure/Auteur
Genitsch, V.
Auteure/Auteur
Zwahlen, D.R.
Auteure/Auteur
Hölscher, T.
Auteure/Auteur
Gut, P.
Auteure/Auteur
Guckenberger, M.
Auteure/Auteur
Hildebrandt, G.
Auteure/Auteur
Müller, A.C.
Auteure/Auteur
Putora, P.M.
Auteure/Auteur
Papachristofilou, A.
Auteure/Auteur
Stalder, L.
Auteure/Auteur
Biaggi-Rudolf, C.
Auteure/Auteur
Sumila, M.
Auteure/Auteur
Kranzbühler, H.
Auteure/Auteur
Najafi, Y.
Auteure/Auteur
Ost, P.
Auteure/Auteur
Azinwi, N.C.
Auteure/Auteur
Reuter, C.
Auteure/Auteur
Bodis, S.
Auteure/Auteur
Khanfir, K.
Auteure/Auteur
Budach, V.
Auteure/Auteur
Aebersold, D.M.
Auteure/Auteur
Thalmann, G.N.
Auteure/Auteur
Groupes de travail
Swiss Group for Clinical Cancer Research (SAKK)
Liens vers les personnes
ISSN
1464-410X
Statut éditorial
Publié
Date de publication
2017-11
Volume
120
Numéro
5B
Première page
E45
Dernière page/numéro d’article
E51
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
To conduct a central pathology review within a randomized clinical trial on salvage radiation therapy (RT) in the presence of biochemical recurrence after prostatectomy to assess whether this results in changes in histopathological prognostic factors, such as Gleason score.
A total of 350 patients were randomized and specimens from 279 patients (80%) were centrally reviewed by a dedicated genitourinary pathologist. Gleason score, tumour classification and resection margin status were reassessed and compared with the results of local pathology review. Agreement was assessed using contingency tables and Cohen's kappa coefficient. The association between other histopathological features (e.g. largest diameter of carcinoma) and rapid biochemical progression (up to 6 months after salvage RT) was also investigated.
There was good concordance between central and local pathology review for seminal vesicle invasion (pT3b: 91%; κ = 0.95 [95% confidence interval {CI} 0.89, 1.00]), extraprostatic extension (pT3a/b: 94%; κ = 0.82 [95% CI 0.75, 0.89]) and positive surgical margin (PSM) status (87%; κ = 0.7 [95% CI 0.62, 0.79]). The rate of agreement was lower for Gleason score (78%; κ = 0.61 [95% CI 0.52, 0.70]). The median (range) largest diameter of carcinoma was 16 (3-38) mm. A total of 49 patients (18%) experienced rapid biochemical progression after salvage RT. Largest diameter of carcinoma (odds ratio [OR] 2.04 [95% CI 1.30, 3.20]; P = 0.002), resection margin status (OR 0.36 [95% CI 0.18, 0.72]; P = 0.004) and Gleason score (OR 1.55 [95% CI 1.00, 2.42]; P = 0.05) remained associated with rapid progression after salvage RT after backward selection.
The results of the central pathology analyses showed concordance between central and local pathology review with regard to seminal vesicle invasion, extraprostatic extension and PSM status, but a lower rate of agreement for Gleason score. Largest diameter of carcinoma was found to be a potential prognostic factor for rapid biochemical progression after salvage RT.
A total of 350 patients were randomized and specimens from 279 patients (80%) were centrally reviewed by a dedicated genitourinary pathologist. Gleason score, tumour classification and resection margin status were reassessed and compared with the results of local pathology review. Agreement was assessed using contingency tables and Cohen's kappa coefficient. The association between other histopathological features (e.g. largest diameter of carcinoma) and rapid biochemical progression (up to 6 months after salvage RT) was also investigated.
There was good concordance between central and local pathology review for seminal vesicle invasion (pT3b: 91%; κ = 0.95 [95% confidence interval {CI} 0.89, 1.00]), extraprostatic extension (pT3a/b: 94%; κ = 0.82 [95% CI 0.75, 0.89]) and positive surgical margin (PSM) status (87%; κ = 0.7 [95% CI 0.62, 0.79]). The rate of agreement was lower for Gleason score (78%; κ = 0.61 [95% CI 0.52, 0.70]). The median (range) largest diameter of carcinoma was 16 (3-38) mm. A total of 49 patients (18%) experienced rapid biochemical progression after salvage RT. Largest diameter of carcinoma (odds ratio [OR] 2.04 [95% CI 1.30, 3.20]; P = 0.002), resection margin status (OR 0.36 [95% CI 0.18, 0.72]; P = 0.004) and Gleason score (OR 1.55 [95% CI 1.00, 2.42]; P = 0.05) remained associated with rapid progression after salvage RT after backward selection.
The results of the central pathology analyses showed concordance between central and local pathology review with regard to seminal vesicle invasion, extraprostatic extension and PSM status, but a lower rate of agreement for Gleason score. Largest diameter of carcinoma was found to be a potential prognostic factor for rapid biochemical progression after salvage RT.
Sujets
PID Serval
serval:BIB_5B1526DA60E9
PMID
Date de création
2019-10-18T14:26:12.823Z
Date de création dans IRIS
2025-05-20T17:03:29Z