TY - JOUR
T1 - Histopathological tumour response scoring in resected pancreatic cancer following neoadjuvant therapy
T2 - international interobserver study (ISGPP-1)
AU - Janssen, Boris V.
AU - van Roessel, Stijn
AU - de Boer, Onno
AU - Adsay, Volkan
AU - Basturk, Olca
AU - Brosens, Lodewijk
AU - Campbell, Fiona
AU - Chatterjee, Deyali
AU - Chou, Angela
AU - Doglioni, Claudio
AU - Esposito, Irene
AU - Feakins, Roger
AU - Fuchs, Talia L.
AU - Fukushima, Noriyoshi
AU - Gill, Anthony J.
AU - Hong, Seung-Mo
AU - Hruban, Ralph H.
AU - Kaplan, Jeffrey
AU - Krasinkas, Alyssa
AU - Luchini, Claudio
AU - Shi, Chanjuan
AU - Singhi, Aatur
AU - Thompson, Elizabeth
AU - Velthuysen, Marie-Louise F.
AU - Besselink, Marc G.
AU - Verheij, Joanne
AU - Wang, Huamin
AU - International Study Group of Pancreatic Pathologists (ISGPP)
AU - Verbeke, Caroline
AU - Fariña, Arantza
AU - van Dieren, Susan
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2022/12/13
Y1 - 2022/12/13
N2 - BACKGROUND: Most tumour response scoring systems for resected pancreatic cancer after neoadjuvant therapy score tumour regression. However, whether treatment-induced changes, including tumour regression, can be identified reliably on haematoxylin and eosin-stained slides remains unclear. Moreover, no large study of the interobserver agreement of current tumour response scoring systems for pancreatic cancer exists. This study aimed to investigate whether gastrointestinal/pancreatic pathologists can reliably identify treatment effect on tumour by histology, and to determine the interobserver agreement for current tumour response scoring systems. METHODS: Overall, 23 gastrointestinal/pancreatic pathologists reviewed digital haematoxylin and eosin-stained slides of pancreatic cancer or treated tumour bed. The accuracy in identifying the treatment effect was investigated in 60 patients (30 treatment-naive, 30 after neoadjuvant therapy (NAT)). The interobserver agreement for the College of American Pathologists (CAP) and MD Anderson Cancer Center (MDACC) tumour response scoring systems was assessed in 50 patients using intraclass correlation coefficients (ICCs). An ICC value below 0.50 indicated poor reliability, 0.50 or more and less than 0.75 indicated moderate reliability, 0.75 or more and below 0.90 indicated good reliability, and above 0.90 indicated excellent reliability. RESULTS: The sensitivity and specificity for identifying NAT effect were 76.2 and 49.0 per cent respectively. After NAT in 50 patients, ICC values for both tumour response scoring systems were moderate: 0.66 for CAP and 0.71 for MDACC. CONCLUSION: Identification of the effect of NAT in resected pancreatic cancer proved unreliable, and interobserver agreement for the current tumour response scoring systems was suboptimal. These findings support the recently published International Study Group of Pancreatic Pathologists recommendations to score residual tumour burden rather than tumour regression after NAT.
AB - BACKGROUND: Most tumour response scoring systems for resected pancreatic cancer after neoadjuvant therapy score tumour regression. However, whether treatment-induced changes, including tumour regression, can be identified reliably on haematoxylin and eosin-stained slides remains unclear. Moreover, no large study of the interobserver agreement of current tumour response scoring systems for pancreatic cancer exists. This study aimed to investigate whether gastrointestinal/pancreatic pathologists can reliably identify treatment effect on tumour by histology, and to determine the interobserver agreement for current tumour response scoring systems. METHODS: Overall, 23 gastrointestinal/pancreatic pathologists reviewed digital haematoxylin and eosin-stained slides of pancreatic cancer or treated tumour bed. The accuracy in identifying the treatment effect was investigated in 60 patients (30 treatment-naive, 30 after neoadjuvant therapy (NAT)). The interobserver agreement for the College of American Pathologists (CAP) and MD Anderson Cancer Center (MDACC) tumour response scoring systems was assessed in 50 patients using intraclass correlation coefficients (ICCs). An ICC value below 0.50 indicated poor reliability, 0.50 or more and less than 0.75 indicated moderate reliability, 0.75 or more and below 0.90 indicated good reliability, and above 0.90 indicated excellent reliability. RESULTS: The sensitivity and specificity for identifying NAT effect were 76.2 and 49.0 per cent respectively. After NAT in 50 patients, ICC values for both tumour response scoring systems were moderate: 0.66 for CAP and 0.71 for MDACC. CONCLUSION: Identification of the effect of NAT in resected pancreatic cancer proved unreliable, and interobserver agreement for the current tumour response scoring systems was suboptimal. These findings support the recently published International Study Group of Pancreatic Pathologists recommendations to score residual tumour burden rather than tumour regression after NAT.
KW - Eosine Yellowish-(YS)
KW - Humans
KW - Neoadjuvant Therapy
KW - Observer Variation
KW - Pancreatic Neoplasms/surgery
KW - Reproducibility of Results
UR - http://www.scopus.com/inward/record.url?scp=85144584678&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/bjs/znac350
DO - https://doi.org/10.1093/bjs/znac350
M3 - Article
C2 - 36331867
SN - 0007-1323
VL - 110
SP - 67
EP - 75
JO - The British journal of surgery
JF - The British journal of surgery
IS - 1
M1 - 10.1093/bjs/znac350
ER -