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Low level of interobserver concordance in assessing histological subtype and tumor grade in patients with penile cancer may impair patient care
Örebro University, School of Medical Sciences. Department of Laboratory Medicine.ORCID iD: 0000-0003-1530-5045
Department of Clinical Genetics and Pathology, Skåne University Hospital and Regional Laboratories, Malmö, Sweden.ORCID iD: 0000-0001-8425-5833
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.ORCID iD: 0000-0002-1749-150X
Pathology, Istituto Di Ricovero E Cure a Carattere Scientifico, Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
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2022 (English)In: Virchows Archiv, ISSN 0945-6317, E-ISSN 1432-2307, Vol. 480, no 4, p. 879-886Article in journal (Refereed) Published
Abstract [en]

Differentiation between penile squamous cell carcinoma patients who can benefit from limited organ-sparing surgery and those at significant risk of lymph node metastasis is based on histopathological prognostic factors including histological grade and tumor histological subtype. We examined levels of interobserver and intraobserver agreement in assessment of histological subtype and grade in 207 patients with penile squamous cell carcinoma. The cases were assessed by seven pathologists from three hospitals located in Sweden and Italy. There was poor to moderate concordance in assessing both histological subtype and grade, with Fleiss kappas of 0.25 (range: 0.02-0.48) and 0.23 (range: 0.07-0.55), respectively. When choosing HPV-associated and non-HPV-associated subtypes, interobserver concordance ranged from poor to good, with a Fleiss kappa value of 0.36 (range: 0.02-0.79). A re-review of the slides by two of the pathologists showed very good intraobserver concordance in assessing histological grade and subtype, with Cohen's kappa values of 0.94 and 0.91 for grade and 0.95 and 0.84 for subtype. Low interobserver concordance could lead to undertreatment and overtreatment of many patients with penile cancer, and brings into question the utility of tumor histological subtype and tumor grade in determining patient treatment in pT1 tumors. 

Place, publisher, year, edition, pages
Springer, 2022. Vol. 480, no 4, p. 879-886
Keywords [en]
Histological grading, Interobserver agreement, Penile cancer, Penile carcinoma subtypes
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-95898DOI: 10.1007/s00428-021-03249-5ISI: 000729009000001PubMedID: 34889977Scopus ID: 2-s2.0-85120917734OAI: oai:DiVA.org:oru-95898DiVA, id: diva2:1619294
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Funding agency:

Örebro University

Available from: 2021-12-13 Created: 2021-12-13 Last updated: 2023-07-05Bibliographically approved

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Dorofte, LuizaDavidsson, SabinaCarlsson, JessicaLillsunde-Larsson, GabriellaKarlsson, Mats G.

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Dorofte, LuizaGrélaud, DianeFiorentino, MichelangeloRicci, CostantinoRiefolo, MattiaDavidsson, SabinaCarlsson, JessicaLillsunde-Larsson, GabriellaKarlsson, Mats G.
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School of Medical SciencesÖrebro University HospitalSchool of Health Sciences
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