Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck

M.W.M. van den Brekel; W.L. Lodder; H.V. Stel; E. Bloemena; C.R. Leemans; I. van der Waal

doi:10.1002/hed.21823

Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck

M.W.M. van den Brekel
, W.L. Lodder
, H.V. Stel
, E. Bloemena
, C.R. Leemans
, I. van der Waal

Maxillofacial Surgery (VUmc)

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background
Extranodal spread (ENS) of tumors is widely used as a prognosticator for patients with head and neck cancer and is used as an indicator for postoperative treatment. However, the histopathologic agreement among pathologists on the assessment of the presence or absence of this criterion has never been studied.

Methods
The interobserver and intraobserver agreement among 10 pathologists on the diagnosis of ENS in 41 tumor-positive lymph nodes was evaluated.

Results
The kappa value of the interobserver agreement among pathologists varied between 0.14 and 0.75, the overall kappa value was 0.42 and 0.49 in the 2 scoring sessions. The intraobserver kappa value varied between 0.49 and 0.95.

Conclusion
The intraobserver and interobserver agreement among pathologists in the assessment of the presence of ENS was low in metastatic lymph nodes in the neck. Because of the widely accepted prognostic significance and therapeutic consequences of ENS, there is a need for internationally accepted reproducible criterion for the histopathologic assessment of ENS in metastatic lymph nodes in the neck.

Original language	English
Pages (from-to)	840-845
Journal	Head and Neck
Volume	34
Issue number	6
DOIs	https://doi.org/10.1002/hed.21823
Publication status	Published - 2012

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SDG 3 Good Health and Well-being

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10.1002/hed.21823

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@article{2bef349d0b83410095e687b7d2c69e93,

title = "Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck",

abstract = "Background Extranodal spread (ENS) of tumors is widely used as a prognosticator for patients with head and neck cancer and is used as an indicator for postoperative treatment. However, the histopathologic agreement among pathologists on the assessment of the presence or absence of this criterion has never been studied. Methods The interobserver and intraobserver agreement among 10 pathologists on the diagnosis of ENS in 41 tumor-positive lymph nodes was evaluated. Results The kappa value of the interobserver agreement among pathologists varied between 0.14 and 0.75, the overall kappa value was 0.42 and 0.49 in the 2 scoring sessions. The intraobserver kappa value varied between 0.49 and 0.95. Conclusion The intraobserver and interobserver agreement among pathologists in the assessment of the presence of ENS was low in metastatic lymph nodes in the neck. Because of the widely accepted prognostic significance and therapeutic consequences of ENS, there is a need for internationally accepted reproducible criterion for the histopathologic assessment of ENS in metastatic lymph nodes in the neck.",

author = "\{van den Brekel\}, M.W.M. and W.L. Lodder and H.V. Stel and E. Bloemena and C.R. Leemans and \{van der Waal\}, I.",

year = "2012",

doi = "10.1002/hed.21823",

language = "English",

volume = "34",

pages = "840--845",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley \& Sons Inc.",

number = "6",

}

TY - JOUR

T1 - Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck

AU - van den Brekel, M.W.M.

AU - Lodder, W.L.

AU - Stel, H.V.

AU - Bloemena, E.

AU - Leemans, C.R.

AU - van der Waal, I.

PY - 2012

Y1 - 2012

N2 - Background Extranodal spread (ENS) of tumors is widely used as a prognosticator for patients with head and neck cancer and is used as an indicator for postoperative treatment. However, the histopathologic agreement among pathologists on the assessment of the presence or absence of this criterion has never been studied. Methods The interobserver and intraobserver agreement among 10 pathologists on the diagnosis of ENS in 41 tumor-positive lymph nodes was evaluated. Results The kappa value of the interobserver agreement among pathologists varied between 0.14 and 0.75, the overall kappa value was 0.42 and 0.49 in the 2 scoring sessions. The intraobserver kappa value varied between 0.49 and 0.95. Conclusion The intraobserver and interobserver agreement among pathologists in the assessment of the presence of ENS was low in metastatic lymph nodes in the neck. Because of the widely accepted prognostic significance and therapeutic consequences of ENS, there is a need for internationally accepted reproducible criterion for the histopathologic assessment of ENS in metastatic lymph nodes in the neck.

AB - Background Extranodal spread (ENS) of tumors is widely used as a prognosticator for patients with head and neck cancer and is used as an indicator for postoperative treatment. However, the histopathologic agreement among pathologists on the assessment of the presence or absence of this criterion has never been studied. Methods The interobserver and intraobserver agreement among 10 pathologists on the diagnosis of ENS in 41 tumor-positive lymph nodes was evaluated. Results The kappa value of the interobserver agreement among pathologists varied between 0.14 and 0.75, the overall kappa value was 0.42 and 0.49 in the 2 scoring sessions. The intraobserver kappa value varied between 0.49 and 0.95. Conclusion The intraobserver and interobserver agreement among pathologists in the assessment of the presence of ENS was low in metastatic lymph nodes in the neck. Because of the widely accepted prognostic significance and therapeutic consequences of ENS, there is a need for internationally accepted reproducible criterion for the histopathologic assessment of ENS in metastatic lymph nodes in the neck.

U2 - 10.1002/hed.21823

DO - 10.1002/hed.21823

M3 - Article

SN - 1043-3074

VL - 34

SP - 840

EP - 845

JO - Head and Neck

JF - Head and Neck

IS - 6

ER -

Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck

Abstract

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