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BOZKURTLAR, EMİNE

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BOZKURTLAR

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EMİNE

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2015 - 20192
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End date: 2019 × Subject: RECURRENCE ×

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    PublicationOpen Access
    Problems in the reproducibility of classification of small lung adenocarcinoma: an international interobserver study
    (2019-11-01) BOZKURTLAR, EMİNE; Shih A. R., Uruga H., BOZKURTLAR E., Chung J., Hariri L. P., Minami Y., Wang H., Yoshizawa A., Muzikansky A., Moreira A. L., et al.
    Aims The 2015 WHO classification for lung adenocarcinoma (ACA) provides criteria for adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (INV), but differentiating these entities can be difficult. As our understanding of prognostic significance increases, inconsistent classification is problematic. This study assesses agreement within an international panel of lung pathologists and identifies factors contributing to inconsistent classification. Methods and results Sixty slides of small lung ACAs were reviewed digitally by six lung pathologists in three rounds, with consensus conferences and examination of elastic stains in round 3. The panel independently reviewed each case to assess final diagnosis, invasive component size and predominant pattern. The kappa value for AIS and MIA versus INV decreased from 0.44 (round 1) to 0.30 and 0.34 (rounds 2 and 3). Interobserver agreement for invasion (AIS versus other) decreased from 0.34 (round 1) to 0.29 and 0.29 (rounds 2 and 3). The range of the measured invasive component in a single case was up to 19.2 mm among observers. Agreement was excellent in tumours with high-grade cytology and fair with low-grade cytology. Conclusions Interobserver agreement in small lung ACAs was fair to moderate, and improved minimally with elastic stains. Poor agreement is primarily attributable to subjectivity in pattern recognition, but high-grade cytology increases agreement. More reliable methods to differentiate histological patterns may be necessary, including refinement of the definitions as well as recognition of other features (such as high-grade cytology) as a formal part of routine assessment.
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    Is Perineural Invasio (PN) a Determinant of Disease Free Survival in Early Stage Colorectal Cancer?
    (H G E UPDATE MEDICAL PUBLISHING S A, 2015) ÇELİKEL, ÇİĞDEM; Ozturk, Mehmet Akif; Dane, Faysal; Karagoz, Sila; Tural, Deniz; Selcukbiricik, Fatih; Demirelli, Fuat; Buyukunal, Evin; Ozguroglu, Mustafa; Turna, Hande; Erdamar, Sibel; Celikel, Cigdem Ataizi; Bozkurtlar, Emine Bas; Yumuk, Perran Fulden; Mandel, Nil Molinas; Turhal, Nazim Serdar; Serdengecti, Suheyla
    Background/Aims: The prognostic importance of perineural invasion (PN) in colorectal cancer (CRC) is unclear. The aim of this study to find out whether the PN was an independent stratification factor of postoperative relapse in curatively resected high-risk stage II & III CRC patients who were treated with adjuvant therapy. Methodology: Data of patients with high risk stage II & all stage III CRCs treated with adjuvant chemotherapy were retrospectively analyzed. Pathological features of final surgical specimen were noted. Disease-free survival was determined by Kaplan-Meier estimator, with differences determined by multivariate analysis using the Cox multiple hazards model. Results were compared using the log-ranktest. Results: PN was found to be positive in 26% in the files of 593 eligible patients. In 21% of the reports PN status was not reported. Presence of PN in the resected primary tumors did not have independent effect on DFS. Further analyses for importance of PN on DFS of colon or rectal cancers did not show any effect. Conclusions: This study had failed to demonstrate any prognostic effect of PN for DFS in surgically resected stage II and III CRC patients who received adjuvant treatments.