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Reproducibility of measurement of myometrial invasion in endometrial carcinoma

(2017) VIRCHOWS ARCHIV. 470(1). p.63-68
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Abstract
Myometrial invasion (MI) as a percentage (%MI), categorized into < 50 or >= 50 %, is an important predictor of prognosis in endometrial carcinoma. Recent studies suggest that tumor-free distance (TFD) to serosa and the absolute depth of invasion (DOI) might be stronger predictors of prognosis. Although reproducibility is important in clinical practice for patient prognostication and treatment, reproducibility of these methods for the measurement of MI is largely unknown. One or two slides from 50 patients with FIGO stage I endometrioid endometrial carcinoma were viewed by seven gynecological pathologists, who were requested to measure %MI, TFD, and DOI. We categorized %MI as < 50 % (including no MI) or >= 50 %, TFD as <= 1.75 or > 1.75 mm (including no MI), <= 7 or > 7 mm (including no MI), and <= 10 or > 10 mm (including no MI) and DOI as < 4 mm (including no MI) or >= 4 mm. Light's kappa for multi-rater agreement was calculated. The %MI, TFD, and DOI could be measured in 88, 83, and 79 % of cases, respectively. Kappa was 0.75 for %MI, 0.77, 0.73, and 0.69 respectively for TFD with cutoffs of 1.75, 7, and 10 mm, and 0.59 for DOI. Pathologists reach substantial agreement when measuring %MI and TFD and moderate agreement when measuring DOI. The %MI can be measured in more cases than TFD and DOI. This supports the use of %MI in daily clinical practice, but future studies should compare %MI and TFD more extensively, including inter-observer variability.
Keywords
Endometrial carcinoma, Myometrial invasion, Depth of invasion, Tumor-free distance, Inter-observer variability, TUMOR-FREE DISTANCE, INTEROBSERVER AGREEMENT, PROGNOSTIC-SIGNIFICANCE, UTERINE SEROSA, CANCER, ADENOCARCINOMA, DEPTH, GRADE, MYOINVASION, SUPERIOR

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Chicago
van der Putten, Louis JM, Koen Van de Vijver, Carla Bartosch, Ben Davidson, Sonia Gatius, Xavier Matias-Guiu, W Glenn McCluggage, et al. 2017. “Reproducibility of Measurement of Myometrial Invasion in Endometrial Carcinoma.” Virchows Archiv 470 (1): 63–68.
APA
van der Putten, L. J., Van de Vijver, K., Bartosch, C., Davidson, B., Gatius, S., Matias-Guiu, X., McCluggage, W. G., et al. (2017). Reproducibility of measurement of myometrial invasion in endometrial carcinoma. VIRCHOWS ARCHIV, 470(1), 63–68.
Vancouver
1.
van der Putten LJ, Van de Vijver K, Bartosch C, Davidson B, Gatius S, Matias-Guiu X, et al. Reproducibility of measurement of myometrial invasion in endometrial carcinoma. VIRCHOWS ARCHIV. 2017;470(1):63–8.
MLA
van der Putten, Louis JM, Koen Van de Vijver, Carla Bartosch, et al. “Reproducibility of Measurement of Myometrial Invasion in Endometrial Carcinoma.” VIRCHOWS ARCHIV 470.1 (2017): 63–68. Print.
@article{8577569,
  abstract     = {Myometrial invasion (MI) as a percentage (\%MI), categorized into {\textlangle} 50 or {\textrangle}= 50 \%, is an important predictor of prognosis in endometrial carcinoma. Recent studies suggest that tumor-free distance (TFD) to serosa and the absolute depth of invasion (DOI) might be stronger predictors of prognosis. Although reproducibility is important in clinical practice for patient prognostication and treatment, reproducibility of these methods for the measurement of MI is largely unknown. One or two slides from 50 patients with FIGO stage I endometrioid endometrial carcinoma were viewed by seven gynecological pathologists, who were requested to measure \%MI, TFD, and DOI. We categorized \%MI as {\textlangle} 50 \% (including no MI) or {\textrangle}= 50 \%, TFD as {\textlangle}= 1.75 or {\textrangle} 1.75 mm (including no MI), {\textlangle}= 7 or {\textrangle} 7 mm (including no MI), and {\textlangle}= 10 or {\textrangle} 10 mm (including no MI) and DOI as {\textlangle} 4 mm (including no MI) or {\textrangle}= 4 mm. Light's kappa for multi-rater agreement was calculated. The \%MI, TFD, and DOI could be measured in 88, 83, and 79 \% of cases, respectively. Kappa was 0.75 for \%MI, 0.77, 0.73, and 0.69 respectively for TFD with cutoffs of 1.75, 7, and 10 mm, and 0.59 for DOI. Pathologists reach substantial agreement when measuring \%MI and TFD and moderate agreement when measuring DOI. The \%MI can be measured in more cases than TFD and DOI. This supports the use of \%MI in daily clinical practice, but future studies should compare \%MI and TFD more extensively, including inter-observer variability.},
  author       = {van der Putten, Louis JM and Van de Vijver, Koen and Bartosch, Carla and Davidson, Ben and Gatius, Sonia and Matias-Guiu, Xavier and McCluggage, W Glenn and Toledo, Gemma and van der Wurff, Anneke AM and Pijnenborg, Johanna MA and Massuger, Leon FAG and Bulten, Johan},
  issn         = {0945-6317},
  journal      = {VIRCHOWS ARCHIV},
  language     = {eng},
  number       = {1},
  pages        = {63--68},
  title        = {Reproducibility of measurement of myometrial invasion in endometrial carcinoma},
  url          = {http://dx.doi.org/10.1007/s00428-016-2035-5},
  volume       = {470},
  year         = {2017},
}

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