Reproducibility of Histopathologic Diagnosis and Classification of Non-Melanocytic Skin Cancer: A Panel Exercise in the Framework of the Multicenter Southern European Study Helios

Author:

Wechsler Janine1,Zanetti Roberto2,Schrameck Cathérine3,Rosso Stefano2,Pippione Mario4,Linares Juan5,Laurent René6,Ortuño Guzman7,Boi Sebastiana8,Gafà Lorenzo9,Joris François10,Spatz Alain11,Barnéon Gilbert12,Sacerdote Carlotta2,Sancho-Garnier Hélène13,Zanetti R14,Rosso S14,Franceschi S15,Talamini R15,Cristofolini M16,Boi S16,Gafà L17,Tumino R17,Schrameck C18,Wechsler J19,Schraub S20,Garnier H Sancho21,Martinez C22,Perea E22,Navarro C23,Tormo MJ23,Joris F24,

Affiliation:

1. Service d'Anatomie et Cytologie Pathologiques, Hôpital Henry Mondor, Créteil, France

2. Registro Tumori Piemonte, CPO, Turin, Italy

3. Service de Biostatistique, Institut Gustave Roussy, Villejuif, France

4. Clinica Dermatologica dell'Università, Turin, Italy

5. Instituto de Anatomia Patologica, Facultad de Mediana, Granada, Spain

6. Service de Dermatologie, CHR de Besançon, France

7. Servicio de Anatomia Patologica, Hospital Santa Maria del Rosell, Murcia, Spain

8. Servizio di Anatomia Patologica, Ospedale Santa Chiara, Trento, Italy

9. Registro Tumori di Ragusa, Ragusa, Italy

10. Registre Valaisan des Tumeurs, Sion, Switzerland

11. Service d'Histopathologic B, Institut Gustave Roussy, Villejuif, France

12. Service d'Anatomie et de Cytologie Pathologiques, CHR, Montpellier, France

13. Epidaure, Espace de Prévention des Cancers, Montpellier, France.

14. Italy – Turin

15. Aviano

16. Trento

17. Ragusa

18. France – Villejuif

19. Créteil

20. Besançon

21. Montpellier

22. Spain – Granada

23. Murcia

24. Switzerland – Sion

Abstract

Aims and background The reproducibility of histologic diagnoses, and in particular of the distinction between basal and squamous cell forms, has been evaluated in the framework of a multicenter case-control study (in Italy, France, Spain and Switzerland) aimed to assess the causes of non-melanocytic skin cancers. Methods A panel composed of 10 pathologists from the collaborating centers was appointed. A total of 1774 slides of routine diagnoses were blindly reviewed by a second panelist; discordant diagnoses underwent a third examination. Controversial and interesting cases were discussed during general sessions. Results The results showed a high degree of concordance (99.5%), with a Cohen's kappa of 0.85 (95% CI, 0.77–0.94) in the assessment of malignancy of lesions. The concordance in the distinction between large morphologic groups, basal cell carcinoma and squamous cell carcinoma was also high (Cohen's kappa = 0.85; 95% CI, 0.82–0.89). The assessment of histologic subtypes, degree of invasion and differentiation showed a lower degree of concordance, presumably as a consequence of a weaker consistency in the relevant classifications. Conclusions The reproducibility study has therefore validated the epidemiologic study and in particular allowed to correct some misclassifications that could have lessened the analysis of the case-control study. In general, because of its characteristics (number of pathologists and variety of their origins, the large number of cases examined, blind examination of histologic slides), the conclusions of the study may show a certain degree of generalization, at least with regard to the countries represented. Routine histologic diagnoses of cutaneous carcinoma showed a high degree of reliability with reference to the assessment of malignancy and the distinction between basal and squamous cell carcinoma morphotypes.

Publisher

SAGE Publications

Subject

Cancer Research,Oncology,General Medicine

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