Universität zu Köln

Garbe, Claus ORCID: 0000-0001-8530-780X, Eigentler, Thomas K., Bauer, Juergen, Bloedorn-Schlicht, Norbert, Cerroni, Lorenzo, Fend, Falko, Hantschke, Markus, Kurschat, Peter, Kutzner, Heinz, Metze, Dieter, Mielke, Volker, Pressler, Harald, Reusch, Michael, Reusch, Ursula, Stadler, Rudolf, Tronnier, Michael, Yazdi, Amir and Metzler, Gisela (2016). Mitotic rate in primary melanoma: interobserver and intraobserver reliability, analyzed using H&E sections and immunohistochemistry. J. Dtsch. Dermatol. Ges., 14 (9). S. 910 - 916. HOBOKEN: WILEY. ISSN 1610-0387

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Abstract

Background: In 2009, the AJCC issued a revised melanoma staging system. In addition to tumor thickness and ulceration, the mitotic rate was introduced as the third major prognostic parameter for the classification of primary cutaneous melanoma. Given that, according to the 2009 AJCC classification, the detection of one or more dermal tumor mitoses leads to an upstaging - from stage Ia to Ib - of melanomas with a tumor thickness of <= 1.0 mm, we set out to investigate the reproducibility of this new parameter. Methods: In order to assess interobserver reliability, 17 dermatopathologists und pathologists - all well versed in the diagnosis of cutaneous melanoma - analyzed the mitotic rate in 15 thin primary cutaneous melanomas (mean tumor thickness 0.91 mm) using identical slides. Mitotic rates were determined on H&E and phosphohistone H3 (Ser10)-stained samples. Without knowledge of their previous assessment, five of the aforementioned examiners reevaluated the samples after more than one year in order to ascertain intraobserver reliability. Results: Interobserver reliability of the mitotic rate in thin primary melanomas is disappointing and independent of whether H&E or immunohistochemically stained samples are used (kappa value: 0.088 [H&E], 0.154 [IH], respectively). Kappa values improved to 0.345 (H&E) and 0.403 (IH) when using a cutoff of 0/1 vs. 2+ mitoses. Similarly unsatisfactory, kappa values for intraobserver reliability ranged from 0.18 and 0.348, depending on the individual examiner. Discussion: Given the unsatisfactory reproducibility and large variations in assessing the mitotic rate, it remains a matter of debate whether this diagnostic parameter should play a role in therapeutic decisions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Garbe, Claus UNSPECIFIED orcid.org/0000-0001-8530-780X UNSPECIFIED Eigentler, Thomas K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Bloedorn-Schlicht, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Cerroni, Lorenzo UNSPECIFIED UNSPECIFIED UNSPECIFIED Fend, Falko UNSPECIFIED UNSPECIFIED UNSPECIFIED Hantschke, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurschat, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kutzner, Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Metze, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Mielke, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Pressler, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Reusch, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Reusch, Ursula UNSPECIFIED UNSPECIFIED UNSPECIFIED Stadler, Rudolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Tronnier, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Yazdi, Amir UNSPECIFIED UNSPECIFIED UNSPECIFIED Metzler, Gisela UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-265651
DOI:	10.1111/ddg.12797
Journal or Publication Title:	J. Dtsch. Dermatol. Ges.
Volume:	14
Number:	9
Page Range:	S. 910 - 916
Date:	2016
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1610-0387
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PRIMARY CUTANEOUS MELANOMA; MALIGNANT-MELANOMA; PHOSPHOHISTONE H3; PROGNOSTIC IMPORTANCE; THIN MELANOMA; FOLLOW-UP; REPRODUCIBILITY Multiple languages Dermatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26565