Current practices in prostate pathology reporting: results from a survey of genitourinary and general pathologists

Mahra Nourbakshs¹, Liping Du², Andres M Acosta³, Reza Alaghehbandan⁴, Ali Amin⁵, Mahul B Amin⁶, Manju Aron⁷, Daniel Berney⁸, Fadi Brimo⁹, Emily Chan¹⁰, Liang Cheng⁵, Maurizio Colecchia¹¹, Jasreman Dhillon¹², Michelle R Downes^{13

14}, Andrew J Evans¹⁵, Lara R Harik¹⁶, Oudai Hassan¹⁷, Aiman Haider¹⁸, Peter A Humphrey¹⁹, Shilpy Jha²⁰, Shivani Kandukuri⁷, Chia-Sui Sunny Kao⁴, Seema Kaushal²¹, Francesca Khani²², Oleksandr N Kryvenko²³, Charlotte Kweldam²⁴, Priti Lal²⁵, Anandi Lobo²⁶, Fiona Maclean²⁷, Cristina Magi-Galluzzi²⁸, Rohit Mehra²⁹, Hiroshi Miyamoto³⁰, Sambit K Mohanty²⁰, Rodolfo Montironi³¹, Gabriella Nesi³², George Jabboure Netto²⁵, Jane K Nguyen⁴, Maya Nourieh³³, Adeboye O Osunkoya¹⁶, Gladell P Paner³⁴, Ankur R Sangoi¹⁰, Rajal B Shah³⁵, John R Srigley¹³, Maria Tretiakova³⁶, Patricia Troncoso³⁷, Kiril Trpkov³⁸, Theodorus H Van Der Kwast³⁹, Miao Zhang³⁷, Debra L Zynger⁴⁰, Sean R Williamson⁴, Giovanna A Giannico^{3

41}

Affiliations

¹ NeoGenomics Laboratories, Aliso Viejo, CA, USA.
² Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Department of Pathology, Indiana University Health, Indianapolis, IN, USA.
⁴ Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.
⁵ Department of Pathology, Alpert Medical School of Brown University, Providence, RI, USA.
⁶ Department of Pathology and Laboratory Medicine, University of Tennessee Health Science, Memphis, TN, USA.
⁷ Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
⁸ Centre of Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK.
⁹ Department of Pathology, McGill University Health Center, Montréal, Quebec, Canada.
¹⁰ Department of Pathology, Stanford Medical Center, Stanford, CA, USA.
¹¹ Department of Pathology, Pathology Unit, Vita-Salute San Raffaele University, Milan, Italy.
¹² Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA.
¹³ Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Department of Anatomic Pathology, Precision Diagnostics & Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
¹⁵ Laboratory Medicine, Mackenzie Health, Toronto, Ontario, Canada.
¹⁶ Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
¹⁷ Department of Surgical Pathology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, MI, USA.
¹⁸ Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
¹⁹ Yale School of Medicine, New Haven, CT, USA.
²⁰ Department of Pathology, Advanced Medical and Research Institute, Bhubaneswar, India.
²¹ Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
²² Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA.
²³ Miller School of Medicine, University of Miami, Miami, FL, USA.
²⁴ Department of Pathology, Maasstad Hospital, Rotterdam, The Netherlands.
²⁵ Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
²⁶ Department of Pathology, Kapoor Centre of Urology and Pathology, Raipur, India.
²⁷ Department of Pathology, Douglass Hanly Moir Pathology, Sydney, NSW, Australia.
²⁸ Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA.
²⁹ Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
³⁰ Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
³¹ Molecular Medicine and Cell Therapy Foundation, c/o Polytechnic University of the Marche Region, Ancona, Italy.
³² Department of Health Sciences, University of Florence, Florence, Italy.
³³ Department of Diagnostic and Theranostic Medicine, Versailles Saint Quentin University UVSQ, Institut CURIE, Saint-Cloud, France.
³⁴ Department of Pathology and Surgery (Urology), The University of Chicago, Chicago, IL, USA.
³⁵ Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
³⁶ Department of Pathology, University of Washington, Seattle, WA, USA.
³⁷ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
³⁸ Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.
³⁹ University Health Network, University of Toronto, Toronto, ON, Canada.
⁴⁰ Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁴¹ Department of Pathology, University of California Irvine, Irvine, CA, USA.

PMID: 40364451
PMCID: PMC12232231
DOI: 10.1111/his.15469

Current practices in prostate pathology reporting: results from a survey of genitourinary and general pathologists

Mahra Nourbakshs et al. Histopathology. 2025 Aug.

. 2025 Aug;87(2):206-222.

doi: 10.1111/his.15469. Epub 2025 May 13.

Authors

Affiliations

¹ NeoGenomics Laboratories, Aliso Viejo, CA, USA.
² Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Department of Pathology, Indiana University Health, Indianapolis, IN, USA.
⁴ Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.
⁵ Department of Pathology, Alpert Medical School of Brown University, Providence, RI, USA.
⁶ Department of Pathology and Laboratory Medicine, University of Tennessee Health Science, Memphis, TN, USA.
⁷ Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
⁸ Centre of Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK.
⁹ Department of Pathology, McGill University Health Center, Montréal, Quebec, Canada.
¹⁰ Department of Pathology, Stanford Medical Center, Stanford, CA, USA.
¹¹ Department of Pathology, Pathology Unit, Vita-Salute San Raffaele University, Milan, Italy.
¹² Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA.
¹³ Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Department of Anatomic Pathology, Precision Diagnostics & Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
¹⁵ Laboratory Medicine, Mackenzie Health, Toronto, Ontario, Canada.
¹⁶ Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
¹⁷ Department of Surgical Pathology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, MI, USA.
¹⁸ Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
¹⁹ Yale School of Medicine, New Haven, CT, USA.
²⁰ Department of Pathology, Advanced Medical and Research Institute, Bhubaneswar, India.
²¹ Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
²² Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA.
²³ Miller School of Medicine, University of Miami, Miami, FL, USA.
²⁴ Department of Pathology, Maasstad Hospital, Rotterdam, The Netherlands.
²⁵ Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
²⁶ Department of Pathology, Kapoor Centre of Urology and Pathology, Raipur, India.
²⁷ Department of Pathology, Douglass Hanly Moir Pathology, Sydney, NSW, Australia.
²⁸ Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA.
²⁹ Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
³⁰ Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
³¹ Molecular Medicine and Cell Therapy Foundation, c/o Polytechnic University of the Marche Region, Ancona, Italy.
³² Department of Health Sciences, University of Florence, Florence, Italy.
³³ Department of Diagnostic and Theranostic Medicine, Versailles Saint Quentin University UVSQ, Institut CURIE, Saint-Cloud, France.
³⁴ Department of Pathology and Surgery (Urology), The University of Chicago, Chicago, IL, USA.
³⁵ Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
³⁶ Department of Pathology, University of Washington, Seattle, WA, USA.
³⁷ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
³⁸ Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.
³⁹ University Health Network, University of Toronto, Toronto, ON, Canada.
⁴⁰ Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁴¹ Department of Pathology, University of California Irvine, Irvine, CA, USA.

PMID: 40364451
PMCID: PMC12232231
DOI: 10.1111/his.15469

Abstract

Aims: Standardizing pathology reporting protocols through peer consensus review is critical for the best quality of care metrics. Reporting heterogeneity due to discrepancies among professional societies and practice patterns may lead to heterogeneous management and treatment approaches. This issue prompted a multi-institutional survey of pathologists to address potential similarities or differences in trends and practice patterns in prostate pathology reporting worldwide.

Methods and results: A REDCap survey was distributed among 175 pathologists worldwide, recruited through invitations and social media. The response rate among invited pathologists was 83%. The practice locations were as follows: North America (USA, Canada, and Mexico, 62%), Europe (17%), Australia/New Zealand (3%), Central/South America (2%), Asia (13%), and Africa (2%). Most pathologists practiced for <5 years (28%). A genitourinary (GU) pathology fellowship was completed by 37%, 58% practiced in a subspecialized setting, and 43% in academia. Reporting includes (63%) or subtracts (37%) intervening benign tissue. Both Gleason score and Grade Groups (GG)s were reported by 96% of responders, whereas 94% report percent pattern 4 (%4). Aggregate grading and volume estimation in undesignated cores with different grades in the same jar are reported by 73% and 54% for systematic biopsies, and 83% and 62% for targeted biopsies, respectively. Cribriform morphology was reported by 81%. For presumed intraductal carcinoma (IDC), 89% use basal cell markers when isolated (iIDC), 82% with GG1 cancer, and 37% with ≥GG2. iIDC or IDC associated with GG1 or with ≥GG2 was not graded by 90%, 78%, and 70%, respectively. In radical prostatectomies, 90% report %4, but only 53% report it if the overall grade is ≥7. A tumour with Gleason 3 + 3 = 6 and <5% pattern 4 was graded as GG2 by 64%. A <5% cutoff for defining tertiary pattern was used by 74%, and 80% report >5% pattern 4 or 5 as a secondary pattern. Grading was assigned based on the dominant nodule by 59%. Finally, reporting practices were significantly associated with demographic characteristics.

Conclusions: Although most issues are agreed upon, significant discordance is identified among societies and pathologists in different practice settings. We hope this survey will serve as the basis for future studies and new collaborative approaches to more standardized reporting practices.

Keywords: prostate; prostate cancer; reporting; survey.

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Conflict of interest statement

All authors report no conflicts of interest or financial disclosures that are pertinent to the study.

References

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Current practices in prostate pathology reporting: results from a survey of genitourinary and general pathologists

Affiliations

Current practices in prostate pathology reporting: results from a survey of genitourinary and general pathologists

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical