Practice patterns in reporting tertiary grades at radical prostatectomy: Survey of a large group of experienced urologic pathologists Journal Article
| Authors: | Fine, S. W.; Meisels, D. L.; Vickers, A. J.; Al-Ahmadie, H.; Chen, Y. B.; Gopalan, A.; Sirintrapun, S. J.; Tickoo, S. K.; Reuter, V. E. |
| Article Title: | Practice patterns in reporting tertiary grades at radical prostatectomy: Survey of a large group of experienced urologic pathologists |
| Abstract: | Context.-In prostate cancer, ''tertiary'' higher-grade patterns (TPs) have been associated with biochemical recurrence after radical prostatectomy. Objective.-To determine variation regarding definition and application of TPs. Design.-Online survey regarding TPs in a range of grading scenarios circulated to 105 experienced urologic pathologists. Results.-Among 95 respondents, 40 of 95 (42%) defined TPs as ''third most common pattern'' and 55 (58%) as ''minor pattern/less than 5% of tumor.'' In a tumor with pattern 3 and less than 5% pattern 4, of the 95 respondents, 35 (37%) assigned 3 + 3 = 6 with TP4, while 56 (59%) assigned 3 + 4 = 7. In a tumor with pattern 4 and less than 5% pattern 5, of the 95 respondents, 51 (54%) assigned 4+4 = 8 with TP5, while 43 (45%) assigned 4 + 5 = 9. Six scenarios were presented in which the order of most common patterns was 3, 4, and 5 (Group 1) or 4, 3, and 5 (Group 2) with varying percentages. In both groups, when pattern 5 was less than 5%, we found that 98% and 93% of respondents would assign 3 + 4 = 7 or 4 + 3 = 7 with TP5. In scenarios with 15% or 25% pattern 5, most respondents (70% and 80%, respectively) would include pattern 5 as the secondary grade, that is, 3 + 5 = 8 (Group 1) or 4 + 5 = 9 (Group 2). For 85 of 95 (89%), a TP would not impact Grade Group assignment. Conclusions.-This survey highlights substantial variation in practice patterns regarding definition and application of ''tertiary'' grading in radical prostatectomy specimens. High consistency was observed in 3 + 4 = 7/4 + 3 = 7 scenarios with truly minor pattern 5. These findings should inform future studies assessing the standardization and predictive value of ''tertiary'' patterns. © 2020 College of American Pathologists. All rights reserved. |
| Journal Title: | Archives of Pathology & Laboratory Medicine |
| Volume: | 144 |
| Issue: | 3 |
| ISSN: | 0003-9985 |
| Publisher: | College of American Pathologists |
| Date Published: | 2020-03-01 |
| Start Page: | 356 |
| End Page: | 360 |
| Language: | English |
| DOI: | 10.5858/arpa.2019-0224-OA |
| PUBMED: | 31584841 |
| PROVIDER: | scopus |
| PMCID: | PMC7480272 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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486Tickoo -
418Gopalan -
400Chen -
887Vickers -
464Fine -
663Al-Ahmadie -
1229Reuter -
202Sirintrapun -
3Meisels
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