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Abstract
Background:
Until recently ovarian
carcinoma was considered to be a single disease, and treatment decisions
were based solely on grade and pre- and postoperative tumour burden.
New insights into molecular features, treatment response, and patient
demographics led the scientific community to conclude that ovarian
carcinoma histotypes are different disease entities.
Methods:
In
2002, the pathology specimens from patients in a clinical trial were
reviewed by an experienced gynaecopathologist (pathologist A) for
translational research purposes. All cases were typed according to what
were then current criteria. The identical cohort was now reassessed by
the same expert pathologist and independently reviewed by another
gynaecopathologist (pathologist B) applying WHO 2014 diagnostic
criteria. Survival analyses were done based on the original as well as
the new diagnoses, and historical biomarker study results were
recalculated.
Results:
Upon re-review, pathologist A rendered the same histotype diagnosis in only 54% of cases. In contrast, pathologists A and B independently rendered the same diagnosis in 98%
of cases. Histotype was of prognostic significance when 2014 diagnoses
were used, but was not prognostic using the original (2002) histotype
diagnoses.
Conclusions:
Our
study demonstrates a marked shift in ovarian carcinoma histotype
diagnosis over the past 15 years. The new criteria are associated with a
very high degree of interobserver reproducibility, allowing for
treatment decisions based on histotype. Finally, biomarkers of putative
prognostic significance were revealed to be primarily histotype-specific
markers, confirming the critical importance of obtaining up-to-date
diagnoses rather than accepting archival histotype data in clinical
research.
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