Agreement for tumor grade of ovarian carcinoma: analysis of archival tissues from the surveillance, epidemiology, and end results residual tissue repository
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Emerging data suggest that ovarian cancers differ by tumor grade. However, the reliability of microscopic grade from paraffin tissue in the general medical community and as reflected in population-based cancer registries is unknown.
We examined grade agreement between two gynecologic pathologists and the Surveillance Epidemiology and End Results Residual Tissue Repository (SEER). Grade agreement was assessed with percent observer agreement and kappa coefficients for 664 invasive ovarian carcinomas, using previously defined three-tier and two-tier grading systems. A random subset of ovarian carcinomas was selected to compare intra- and inter-pathologist agreement.
Five hundred and eighty-six of SEER’s 664 tumors were confirmed invasive. Percent agreement was 49 % with fair kappa coefficient = 0.25 (95 % CI: 0.20–0.30) for the 664 tumors. Agreement improved slightly when restricted to the 586 confirmed invasive cancers; it was better for high grade than low grade tumors, for two-tier than three-tier grading systems, and within (66 %) than between study pathologists (43 %). Grade was not a robust independent predictor of ovarian cancer-specific survival.
Grade agreement was fair between SEER and study pathologists irrespective of grading system. Recorded grade in SEER should be used with caution and is probably not a reliable metric for ovarian cancer epidemiology.
KeywordsEpidemiology Ovarian cancer Tumor grade SEER Kappa coefficient
- 8.Classification and staging of malignant tumors in the female pelvis, accepted by the General Assembly of FIGO in New York, April 12, 1970. Acta Obstet Gynecol Scand 50(1):1–7Google Scholar
- 11.Shimizu Y, Kamoi S, Amada S, Hasumi K, Akiyama F, Silverberg SG (1998) Toward the development of a universal grading system for ovarian epithelial carcinoma. I. Prognostic significance of histopathologic features–problems involved in the architectural grading system. Gynecol Oncol 70(1):2–12PubMedCrossRefGoogle Scholar
- 16.SEER-Surveillance Epidemiology and End Results (2012) [cited 2012 February 06]; Available from: http://seer.cancer.gov/
- 18.AJCC (2011) Ovary and primary peritoneal carcinoma. In: Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds) AJCC cancer staging manual, 7th edn. Springer, New York, pp 419–428Google Scholar
- 19.International Classification of Diseases for Oncology 3rd ed (2000) In: Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, Whelan S (eds) U.S. Interim Version 2000. World Health Organization, GenevaGoogle Scholar
- 24.Sugiyama T, Kamura T, Kigawa J, Terakawa N, Kikuchi Y, Kita T et al (2000) Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer 88(11):2584–2589 (Epub 2000/06/22)PubMedCrossRefGoogle Scholar
- 28.Last JM (1995) A dictionary of epidemiology, 3rd edn. Oxford University Press, OxfordGoogle Scholar
- 29.Seidman JD, Yemelyanova A, Cosin JA, Smith A, Kurman RJ (2012) Survival rates for international federation of gynecology and obstetrics stage III ovarian carcinoma by cell type: a study of 262 unselected patients with uniform pathologic review. Int J Gynecol Cancer 22(3):367–371 (Epub 2012/01/13)PubMedCrossRefGoogle Scholar