Format

Send to

Choose Destination
Histopathology. 2019 Jun;74(7):1014-1024. doi: 10.1111/his.13829. Epub 2019 Apr 14.

Reproducibility of the peritoneal regression grading score for assessment of response to therapy in peritoneal metastasis.

Author information

1
Institute of Pathology and Neuropathology, Eberhard-Karls-University Tuebingen and National Center for Pleura and Peritoneum, University of Tuebingen, Tuebingen, Germany.
2
Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland.
3
Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.
4
Institute of Pathology, University Caen and Réseau National des Tumeurs Rares du Péritoine (RENAPE), Caen, France.
5
Institute of Pathology, Paracelsus Medical University, Salzburger Landeskliniken (SALK), Salzburg, Austria.
6
Department of Surgery, Paracelsus Medical University, Salzburg, Austria.
7
Department of Pathology, Odense University Hospital, Odense, Denmark.
8
Odense PIPAC Center (OPC) and Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark.
9
Department of Surgery, HPB and Upper GI Section, Odense University Hospital, Odense, Denmark.
10
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.

Abstract

AIMS:

The four-tiered peritoneal regression grading score (PRGS) assesses the response to chemotherapy in peritoneal metastasis (PM). The PRGS is used, for example, to assess the response to pressurised intraperitoneal aerosol chemotherapy (PIPAC). However, the reproducibility of the PRGS is currently unknown. We aimed to evaluate the inter- and intraobserver variability of the PRGS.

METHODS AND RESULTS:

Thirty-three patients who underwent at least three PIPAC treatments as part of the PIPAC-OPC1 or PIPAC-OPC2 clinical trials at Odense University Hospital, Denmark, were included. Prior to each therapy cycle, peritoneal quadrant biopsies were obtained and three haematoxylin and eosin (H&E)-stained step sections were scanned and uploaded to a pseudonymised web library. For determining interobserver variability, eight pathologists assessed the PRGS for each quadrant biopsy, and Krippendorff's alpha and intraclass correlation coefficients (ICCs) were calculated. For determining intraobserver variability, three pathologists repeated their own assessments and Cohen's kappa and ICCs were calculated. A total of 331 peritoneal biopsies were analysed. Interobserver variability for PRGS of each biopsy and for the mean and maximum PRGS per biopsy set was moderate to good/substantial. The intraobserver variability for PRGS of each biopsy and for the mean and maximum PRGS per biopsy set was good to excellent/almost perfect.

CONCLUSIONS:

Our data support the PRGS as a reproducible and useful tool to assess response to intraperitoneal chemotherapy in PM. Future studies should evaluate the prognostic and predictive role of the PRGS.

KEYWORDS:

colorectal cancer; gastric cancer; interobserver variability; ovarian cancer; pancreatic cancer; peritoneal metastasis; pressurised intraperitoneal aerosol chemotherapy; tumour regression grading

PMID:
30687944
DOI:
10.1111/his.13829

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center