title: Variation between specialist uropatholgists in reporting extraprostatic extension after radical prostatectomy.
abstract: OBJECTIVE
  Extraprostatic extension of prostate cancer in radical prostatectomy specimens significantly affects patient management. We evaluated the degree of interobserver variation between uropathologists at a tertiary referral teaching hospital in assessing the extraprostatic extension of prostate cancer in radical prostatectomy specimens.
  
  
  METHODS
  Histopathological data from a consecutive series of 293 radical prostatectomy specimens (January 2007-December 2012) were reviewed. A subset of 50 consecutive radical prostatectomy cases originally staged as tumours confined to the prostate (pT2) or tumours extending into periprostatic tissue (pT3a) during this period were reviewed by four specialist uropathologists.
  
  
  RESULTS
  Five consultant histopathologists reported these specimens with significant differences in the reported stage (p=0.0164) between pathologists. Double-blind review by 4 uropathologists of 50 consecutive radical prostatectomy cases showed a lack of consensus in 16/50 (32%) cases (κ score 0.58, moderate agreement). A consensus meeting was held, but consensus could still not be reached in 9/16 cases.
  
  
  CONCLUSIONS
  Our findings highlight variability in the reporting of pT stage in radical prostatectomy specimens even by specialist uropathologists. Assessment of extraprostatic extension has important implications for patient management and there is a need for more precise guidance.
authors: Nuffield Department of Surgical Sciences, University of Oxford, Old Road Campus Research Building (off Roosevelt Drive), Oxford, UK Department of Urology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, UK.
authors: Richard J
authors: RJ
authors: Bryant
authors: Department of Cellular Pathology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
authors: Anne J
authors: AJ
authors: Schmitt
authors: Department of Cellular Pathology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
authors: Ian S D
authors: IS
authors: Roberts
authors: Department of Cellular Pathology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
authors: Pelvender S
authors: PS
authors: Gill
authors: Department of Cellular Pathology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
authors: Lisa
authors: L
authors: Browning
authors: Department of Urology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, UK.
authors: Simon F
authors: SF
authors: Brewster
authors: Nuffield Department of Surgical Sciences, University of Oxford, Old Road Campus Research Building (off Roosevelt Drive), Oxford, UK Department of Urology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, UK.
authors: Freddie C
authors: FC
authors: Hamdy
authors: Department of Cellular Pathology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
authors: Clare
authors: C
authors: Verrill
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003253:Consultants; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015588:Observer Variation; D010338:Pathology, Clinical / Q000592:standards*; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D014572:Urology / Q000592:standards*
keywords: CANCER; PROSTATE; QUALITY ASSURANCE