Year: 2025
Type: article
Study design: Observational Study
Abstract: G leason Score is the most widely used grading system for prostate adenocarcinoma and is the strongest predictor of the patient's clinical outcome.It is used in patient-specific treatment planning to decide if surgery, radiotherapy, or hormonal therapy will be applied.The scoring system proposed by Gleason et al.[1] includes 5 patterns based on the structural features of the tumor.The two most dominant patterns are given in order.The Gleason score represents the sum of these two patterns, while the grade group, introduced in the 2016 WHO classification, is a five-tier system emphasizing the most common pattern [1].The Gleason score plays a critical role in the management and treatment of prostate cancer and is an important tool for predicting the biological aggressiveness and prognosis of cancer.Gleason score serves as a fundamental factor in determining patients' risk groups and evaluating treatment options.Patients are categorized into very low, low, intermediate, high, and very high-risk groups based on clinical factors such as Gleason score ABSTRACT OBJECTIVE: The Gleason Score is the most widely used grading system for prostate adenocarcinoma and it is the strongest predictor of the patient's clinical outcome similar to other grading systems, and plays a key role in determining the most effective treatment strategy for the patient.The Gleason scoring system is subject to both intraobserver and interobserver variability.This study aims to assess the interobserver agreement for prostate adenocarcinoma within the Gleason grading system at our center, as well as identify contributing factors.METHODS: A total of 119 cases diagnosed with prostatic adenocarcinoma at Giresun Training and Research Hospital were included in the study.Tissue samples from the cases had been subjected to routine laboratory procedures; three-micron sections were obtained from formalin-fixed paraffin blocks and stained H&E.Statistical investigation was conducted on the agreement between Gleason pattern, Gleason sum score, and grade group data among three observers. RESULTS:In the evaluation, interobserver agreement was found to be minimal (Gleason pattern k=0.285, total Gleason sum score k=0.309,Grade group k=0.313).The assessment indicated higher agreement in determining low grade compared to high grade, with a decrease in interobserver agreement as the grade increased.Moreover, interobserver agreement demonstrated an increase over the years (p<0.001). CONCLUSION:The findings underscore the ongoing inadequacy of interobserver agreement in the Gleason scoring system.Improvement suggestions involve conducting studies to ascertain in-clinic interobserver agreement enhancing training, facilitating information sharing, and employing accessible and easily applicable artificial intelligence-supported programs.
Source: Northern Clinics of Istanbul
Author: Ilkay Cinar
Institution: Giresun University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411887444