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Central Pathology Review of Radical Prostatectomy Specimens from Men in the PLCO Cancer Screening Trial

Principal Investigator
Name
Gerald Andriole
Institution
Washington University in St. Louis
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
2008-0004
Initial CDAS Request Approval
Mar 27, 2008
Title
Central Pathology Review of Radical Prostatectomy Specimens from Men in the PLCO Cancer Screening Trial
Summary
Gleason histological grade remains the most powerful single predictor of the outcome of men with prostate cancer (1). In the PLCO Cancer Screening Trial, individual men who are discovered to have prostate cancer in either the screening or control arms have diagnosis and Gleason grading determined by their local pathologist. There is known to be significant inter-pathologist variation in the community in assignment of Gleason scores (2), compared to substantial agreement amongst urologic pathologists (3), so central review by a panel of expert urologic pathologists is the optimal means of assigning Gleason scores. Furthermore, the Gleason system was recently modified (4) and it is critical that the modified system be used for PLCO cases. The three members of this panel helped devise the modified system (4). In this study, representative sections of radical prostatectomy specimens for PLCO participants will be reviewed by 3 expert urologic pathologists
Aims

1. We will establish a voluntary PLCO Pathology Panel of 3 urologic pathologists to review histologic slides of prostatic carcinoma 2. Each PLCO Pathology Panel Member will provide histologic Gleason grade using the new modified Gleason scoring and record the results on a form developed for the study. Most, if not all, PLCO radical prostatectomy specimens will be submitted to CGEMS for tissue array. During this process, an extra slide will be prepared and circulated among the expert panel for independent assignment of Gleason Score. Each member of the panel will independently assign a Gleason Score, the results of which will be collated centrally and "final" consensus Gleason Score assigned. Disagreements will be resolved by review of static digital and/or virtual slide images. a. Interobserver reproducibility between contributing pathologist Gleason score and consensus Panel Gleason score will be assessed as crude percentages and kappa statistics b. Gleason score of screen-detected vs. non-screen-detected prostatic adenocarcinomas from the control arm will be compared for differences c. Interobserver reproducibility between Gleason score assigned by the U.S. Panel and an European EORTC Panel, headed by Dr. Theo van der Kwast, will be assessed as crude percentages and kappa statistics. The EORTC Panel will review the slides after the PLCO Panel.

Collaborators

C. Bey
Johnathan Epstein (Johns Hopkins)
Lawrence Ragard
Scott Lucia (University of Colorado)
Peter Humphrey (Washington University in St. Louis)