دورية أكاديمية
Clinical consequences of upfront pathology review in the randomised PORTEC-3 trial for high-risk endometrial cancer
| العنوان: | Clinical consequences of upfront pathology review in the randomised PORTEC-3 trial for high-risk endometrial cancer |
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| المؤلفون: | de Boer, SM, Wortman, BG, Bosse, T, Powell, ME, Singh, N, Hollema, H, Wilson, G, Chowdhury, MN, Mileshkin, L, Pyman, J, Katsaros, D, Carinelli, S, Fyles, A, McLachlin, CM, Haie-Meder, C, Duvillard, P, Nout, RA, Verhoeven-Adema, KW, Putter, H, Creutzberg, CL, Smit, VTHBM |
| بيانات النشر: | ELSEVIER |
| سنة النشر: | 2018 |
| المجموعة: | The University of Melbourne: Digital Repository |
| الوصف: | BACKGROUND: In the PORTEC-3 trial, women with high-risk endometrial cancer (HR-EC) were randomised to receive pelvic radiotherapy (RT) with or without concurrent and adjuvant chemotherapy (two cycles of cisplatin 50 mg/m2 in weeks 1 and 4 of RT, followed by four cycles of carboplatin AUC5 and paclitaxel 175 mg/m2). Pathology review was required before patient enrolment. The aim of this analysis was to evaluate the role of central pathology review before randomisation. PATIENTS AND METHODS: A total of 1295 cases underwent pathology review to confirm HR-EC in the Netherlands (n = 395) and the UK (n = 900), and for 1226/1295 (95%) matching review and original reports were available. In total, 329 of these patients were enrolled in the PORTEC-3 trial: 145 in the Netherlands and 184 in the UK, comprising 48% of the total PORTEC-3 cohort of 686 participants. Areas of discrepancies were evaluated, and inter-observer agreement between original and review opinion was evaluated by calculating the kappa value (κ). RESULTS: In the 1226 pathology reviews, 6356 selected items were evaluable for both original and review pathology. In 43% of cases at least one pathology item changed after review. For 102 patients (8%), this discrepancy led to ineligibility for the PORTEC-3 trial, most frequently due to differences in the assessment of histological type (34%), endocervical stromal involvement (27%) and histological grade (19%). Lowest inter-observer agreement was found for histological type (κ = 0.72), lymph-vascular space invasion (κ = 0.72) and histological grade (κ = 0.70). CONCLUSION: Central pathology review by expert gynaeco-pathologists changed histological type, grade or other items in 43% of women with HR-EC, leading to ineligibility for the PORTEC-3 trial in 8%. Upfront pathology review is essential to ensure enrolment of the target trial-population, and to avoid over- or undertreatment, especially when treatment modalities with substantial toxicity are involved. This study is registered with ISRCTN (ISRCTN14387080, ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0923-7534 1569-8041 |
| العلاقة: | pii: S0923-7534(19)35063-X; de Boer, S. M., Wortman, B. G., Bosse, T., Powell, M. E., Singh, N., Hollema, H., Wilson, G., Chowdhury, M. N., Mileshkin, L., Pyman, J., Katsaros, D., Carinelli, S., Fyles, A., McLachlin, C. M., Haie-Meder, C., Duvillard, P., Nout, R. A., Verhoeven-Adema, K. W., Putter, H. ,. Smit, V. T. H. B. M. (2018). Clinical consequences of upfront pathology review in the randomised PORTEC-3 trial for high-risk endometrial cancer. ANNALS OF ONCOLOGY, 29 (2), pp.424-430. https://doi.org/10.1093/annonc/mdx753Test.; http://hdl.handle.net/11343/253209Test |
| الإتاحة: | https://doi.org/10.1093/annonc/mdx753Test http://hdl.handle.net/11343/253209Test |
| حقوق: | CC BY ; https://creativecommons.org/licenses/by/4.0Test |
| رقم الانضمام: | edsbas.CE6D4B1D |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 09237534 15698041 |
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