Reporting Guidelines for Prostate Biopsies – A Survey of 266 European Pathologists
D Berney, F Algaba, P Camparo, E Comperat, D Griffiths, G Kristiansen, A Lopez-Beltran, R Montironi, M Varma, L Egevad. St Bartholomew' Hospital, London, United Kingdom; Fundacio Puigvert-University Autonomous, Barcelona, Spain; Centre de Pathologie Amiens Picardie, Paris, France; Hopital La Pitié-Salpetrière, Paris, France; University Hospital of Wales, Cardiff, United Kingdom; University of Bonn, Bonn, Germany; Cordoba University Medical School, Cordoba, United Kingdom; Polytechnic University of the Marche Region, Ancona, United Kingdom; Karolinska Institutet, Stockholm, Sweden
Background: It is not known how European uropathologists currently report histopathological features of cancer such as core length, tumour length, peri-neural invasion and non-tumour associated features such as inflammation and hyperplasia in needle biopsies.
Design: A web-based survey was distributed among 661 members of the European Network of Uropathology (ENUP).
Results: Complete replies were received from 266 pathologists in 22 European countries. Total core lengths were reported by 64%, the majority were measured on wet specimens by laboratory technicians. The numbers of cores positive for cancer was given by 79% while 14% would report biopsies separately without summarizing numbers. Linear cancer extent was reported by 81%, most often given in mm for each core (53%) followed by estimation of percentage of cancer in each core (40%). Total extent of cancer in all cores was given in mm (22%), as an estimated percentage (25%) or by calculating exact percentages from core lengths (17%). A gap of benign tissue between separate cancer foci in a single core would always be subtracted by 48% while even a wide gap would be included in tumour extent by 27%. Peri-neural invasion was reported by 97%. Fat invasion by tumor was interpreted as extraprostatic extension by 81%. Chronic and active/acute inflammation was always reported by 32% and 56% but only if pronounced by 54% and 39%, respectively. While most (79%) would never diagnose benign prostatic hyperplasia on needle biopsy, 21% would attempt to make this diagnosis (13% sometimes, 8% often).
Conclusions: Reporting practices for prostate biopsies are variable among European pathologists. In line with international guidelines, the vast majority report the number of biopsies positive for cancer and linear extent but the methodologies used for this vary widely. Despite uncertain clinical relevance, most pathologists report inflammation, at least if pronounced, and some even attempt to diagnose benign prostatic hyperplasia in needle biopsies. The great variation in methodologies used suggests a need for further international consensus, in order for retrospective data to be comparable between different institutions.
Category: Genitourinary (including renal tumors)
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 81, Tuesday Morning