title: Reproducibility of measurement of myometrial invasion in endometrial carcinoma.
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.
authors: Department of Obstetrics and Gynaecology, Radboud university medical center, Geert Grooteplein 10, P.O. Box 9101, 6525 GA, Nijmegen, the Netherlands. Louis.vanderputten@radboudumc.nl.
authors: Louis J M
authors: LJ
authors: van der Putten
authors: Department of Pathology, Anthoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX, Amsterdam, the Netherlands.
authors: Koen
authors: K
authors: van de Vijver
authors: Department of Pathology, Portuguese Oncology Institute-Porto, R. Dr. António Bernardino de Almeida, 4200, Porto, Portugal.
authors: Carla
authors: C
authors: Bartosch
authors: Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Ullernchausseen 70, 0379, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: Ben
authors: B
authors: Davidson
authors: Department of Pathology, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.
authors: Sonia
authors: S
authors: Gatius
authors: Department of Pathology, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.
authors: Xavier
authors: X
authors: Matias-Guiu
authors: Department of Pathology, Belfast Health & Social Care Trust, Knockbracken Healthcare, Saintfield Rd, Belfast, County Antrim, BT8 8BH, UK.
authors: W Glenn
authors: WG
authors: McCluggage
authors: Department of Pathology, MD Anderson Cancer Center, Calle de Arturo Soria, 270, 28033, Madrid, Spain.
authors: Gemma
authors: G
authors: Toledo
authors: Department of Pathology, St. Elisabeth Hospital, Hilvarenbeekse Weg 60, 5022 GC, Tilburg, the Netherlands.
authors: Anneke A M
authors: AA
authors: van der Wurff
authors: Department of Obstetrics and Gynecology, TweeSteden Hospital, Doctor Deelenlaan 5, 5042 AD, Tilburg, the Netherlands.
authors: Johanna M A
authors: JM
authors: Pijnenborg
authors: Department of Obstetrics and Gynaecology, Radboud university medical center, Geert Grooteplein 10, P.O. Box 9101, 6525 GA, Nijmegen, the Netherlands.
authors: Leon F A G
authors: LF
authors: Massuger
authors: Department of Pathology, Radboud university medical center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands.
authors: Johan
authors: J
authors: Bulten
mesh_terms: D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D015588:Observer Variation; D011379:Prognosis; D015203:Reproducibility of Results
keywords: Depth of invasion; Endometrial carcinoma; Inter-observer variability; Myometrial invasion; Tumor-free distance