EAU 2019: Does Size Matter? A Comparison of Gleason Score Concordance Rate Between 23 Belgian Centers
The study took place in 23 Belgian centers between 2009 and 2016 including 8,021 patients who underwent robotic radical prostatectomy. The concordance rate between the biopsy and final specimen pathology Gleason score was assessed.
The results demonstrated that the concordance rate was 60.5% for the entire population, and upgrading was seen in 28.6% of patients. A significant effect of center size on the concordance rate could not be identified (p=0.4). However, when stratifying centers by size, variations could be seen. In centers that performed 50-100 procedures per year, 3 of the 9 centers had concordance rate higher than the mean. Two centers that performed >100 procedures per year, but unexpectedly, one of these center scored below the mean.
The authors concluded that there is a discrepancy between good and poor performers. Size did not seem to correlate with the concordance rate in this study. One possible explanation is that high volume centers have a higher proportion of referrals and their biopsy results, performed outside the hospital, are not reviewed by their own hospital specialist pathologists. The authors importantly add that in general, use of mpMRI-informed biopsies, pathologist training, and review of outside biopsy results could improve concordance rates.
Presented by: Charlotte Soenens, Resident Urologist, AZ Maria Middelares, Department of Urology, Ghent, Belgium
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona, Spain, March 15-19, 2019.