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

Détails

ID Serval
serval:BIB_5B1526DA60E9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Importance and outcome relevance of central pathology review in prostatectomy specimens: data from the SAKK 09/10 randomized trial on prostate cancer.
Périodique
BJU international
Auteur(s)
Ghadjar P., Hayoz S., Genitsch V., Zwahlen D.R., Hölscher T., Gut P., Guckenberger M., Hildebrandt G., Müller A.C., Putora P.M., Papachristofilou A., Stalder L., Biaggi-Rudolf C., Sumila M., Kranzbühler H., Najafi Y., Ost P., Azinwi N.C., Reuter C., Bodis S., Khanfir K., Budach V., Aebersold D.M., Thalmann G.N.
Collaborateur(s)
Swiss Group for Clinical Cancer Research (SAKK)
ISSN
1464-410X (Electronic)
ISSN-L
1464-4096
Statut éditorial
Publié
Date de publication
11/2017
Peer-reviewed
Oui
Volume
120
Numéro
5B
Pages
E45-E51
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
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.
Mots-clé
Aged, Clinical Trials, Phase III as Topic, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Male, Middle Aged, Neoplasm Grading, Neoplasm Recurrence, Local/pathology, Predictive Value of Tests, Prostate-Specific Antigen, Prostatectomy, Prostatic Neoplasms/pathology, Radiotherapy, Adjuvant, Random Allocation, Randomized Controlled Trials as Topic, Retrospective Studies, Salvage Therapy, Treatment Outcome, #PCSM, #ProstateCancer, central pathology review, radiation, salvage
Pubmed
Web of science
Création de la notice
18/10/2019 15:26
Dernière modification de la notice
19/10/2019 5:26
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