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Importance and outcome relevance of central pathology review in prostatectomy specimens : data from the SAKK 09/10 randomized trial on prostate cancer

(2017) BJU INTERNATIONAL. 120(5B). p.E45-E51
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Abstract
Objective : 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. Patients and Methods : 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. Results : There was good concordance between central and local pathology review for seminal vesicle invasion (pT3b: 91%; kappa = 0.95 [95% confidence interval {CI} 0.89, 1.00]), extraprostatic extension (pT3a/b: 94%; kappa = 0.82 [95% CI 0.75, 0.89]) and positive surgical margin (PSM) status (87%; kappa = 0.7 [95% CI 0.62, 0.79]). The rate of agreement was lower for Gleason score (78%; kappa = 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. Conclusion : 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.
Keywords
central pathology review, radiation, salvage, #ProstateCancer, #PCSM, SALVAGE RADIATION-THERAPY, ISUP CONSENSUS CONFERENCE, RADICAL PROSTATECTOMY, INTERNATIONAL-SOCIETY, IMPACT

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MLA
Ghadjar, Pirus, et al. “Importance and Outcome Relevance of Central Pathology Review in Prostatectomy Specimens : Data from the SAKK 09/10 Randomized Trial on Prostate Cancer.” BJU INTERNATIONAL, vol. 120, no. 5B, 2017, pp. E45–51, doi:10.1111/bju.13742.
APA
Ghadjar, P., Hayoz, S., Genitsch, V., Zwahlen, D. R., Hölscher, T., Gut, P., … Thalmann, G. N. (2017). Importance and outcome relevance of central pathology review in prostatectomy specimens : data from the SAKK 09/10 randomized trial on prostate cancer. BJU INTERNATIONAL, 120(5B), E45–E51. https://doi.org/10.1111/bju.13742
Chicago author-date
Ghadjar, Pirus, Stefanie Hayoz, Vera Genitsch, Daniel R Zwahlen, Tobias Hölscher, Philipp Gut, Matthias Guckenberger, et al. 2017. “Importance and Outcome Relevance of Central Pathology Review in Prostatectomy Specimens : Data from the SAKK 09/10 Randomized Trial on Prostate Cancer.” BJU INTERNATIONAL 120 (5B): E45–51. https://doi.org/10.1111/bju.13742.
Chicago author-date (all authors)
Ghadjar, Pirus, Stefanie Hayoz, Vera Genitsch, Daniel R Zwahlen, Tobias Hölscher, Philipp Gut, Matthias Guckenberger, Guido Hildebrandt, Arndt-Christian Müller, Paul M Putora, Alexandros Papachristofilou, Lukas Stalder, Christine Biaggi-Rudolf, Marcin Sumila, Helmut Kranzbühler, Yousef Najafi, Piet Ost, Ngwa C Azinwi, Christiane Reuter, Stephan Bodis, Kaouthar Khanfir, Volker Budach, Daniel M Aebersold, and George N Thalmann. 2017. “Importance and Outcome Relevance of Central Pathology Review in Prostatectomy Specimens : Data from the SAKK 09/10 Randomized Trial on Prostate Cancer.” BJU INTERNATIONAL 120 (5B): E45–E51. doi:10.1111/bju.13742.
Vancouver
1.
Ghadjar P, Hayoz S, Genitsch V, Zwahlen DR, Hölscher T, Gut P, et al. Importance and outcome relevance of central pathology review in prostatectomy specimens : data from the SAKK 09/10 randomized trial on prostate cancer. BJU INTERNATIONAL. 2017;120(5B):E45–51.
IEEE
[1]
P. Ghadjar et al., “Importance and outcome relevance of central pathology review in prostatectomy specimens : data from the SAKK 09/10 randomized trial on prostate cancer,” BJU INTERNATIONAL, vol. 120, no. 5B, pp. E45–E51, 2017.
@article{8505250,
  abstract     = {Objective : 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. 
Patients and Methods : 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. 
Results : There was good concordance between central and local pathology review for seminal vesicle invasion (pT3b: 91%; kappa = 0.95 [95% confidence interval {CI} 0.89, 1.00]), extraprostatic extension (pT3a/b: 94%; kappa = 0.82 [95% CI 0.75, 0.89]) and positive surgical margin (PSM) status (87%; kappa = 0.7 [95% CI 0.62, 0.79]). The rate of agreement was lower for Gleason score (78%; kappa = 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. 
Conclusion : 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.},
  author       = {Ghadjar, Pirus and Hayoz, Stefanie and Genitsch, Vera and Zwahlen, Daniel R and Hölscher, Tobias and Gut, Philipp and Guckenberger, Matthias and Hildebrandt, Guido and Müller, Arndt-Christian and Putora, Paul M and Papachristofilou, Alexandros and Stalder, Lukas and Biaggi-Rudolf, Christine and Sumila, Marcin and Kranzbühler, Helmut and Najafi, Yousef and Ost, Piet and Azinwi, Ngwa C and Reuter, Christiane and Bodis, Stephan and Khanfir, Kaouthar and Budach, Volker and Aebersold, Daniel M and Thalmann, George N},
  issn         = {1464-4096},
  journal      = {BJU INTERNATIONAL},
  keywords     = {central pathology review,radiation,salvage,#ProstateCancer,#PCSM,SALVAGE RADIATION-THERAPY,ISUP CONSENSUS CONFERENCE,RADICAL PROSTATECTOMY,INTERNATIONAL-SOCIETY,IMPACT},
  language     = {eng},
  number       = {5B},
  pages        = {E45--E51},
  title        = {Importance and outcome relevance of central pathology review in prostatectomy specimens : data from the SAKK 09/10 randomized trial on prostate cancer},
  url          = {http://dx.doi.org/10.1111/bju.13742},
  volume       = {120},
  year         = {2017},
}

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