• Sven Gunia, Maximilian Burger, Oliver W Hakenberg, Dieter May, Stefan Koch, Anjun Jain, Kristina Birnkammer, Wolf F Wieland, Wolfgang Otto, Ferdinand Hofstädter, Hans-Martin Fritsche, Stefan Denzinger, Christian Gilfrich, Sabine Brookman-May, and Matthias May.
• Institute of Pathology, Johanniter Hospital Stendal, Stendal, Germany. sven-gunia @ gmx.de
• Urol. Int. 2013 Jan 1; 90 (2): 207-13.

IntroductionWe assessed the reproducibility and prognostic impact of the Broders' grading system (BGS) in a cohort of 147 patients with surgically treated penile squamous cell carcinomas.Materials And MethodsConventionally stained histology slides were graded according to the BGS in two rounds by two study pathologists. Reproducibility was assessed using ĸ statistics. Multivariable analyses were calculated to predict cancer-specific survival (CSS). The 'mean grade' per pathologist per round was calculated by allocating grade points to each study case (G1-G4: 1-4 points) and dividing the sum of all grade points by the number of cases examined.ResultsThe BGS showed substantial interobserver variation (59-87% with ĸ = 0.38-0.69) but almost perfect intraobserver reproducibility (91% with ĸ = 0.86 and 96% with ĸ = 0.94, respectively). The 'mean grade' per pathologist remained nearly constant in both rounds of examination (differences ≤0.05 grade points) but differed between the two pathologists (up to 0.4 grade points). In multivariable analyses, the prognostic impact of the BGS in terms of CSS was strongly pathologist-dependent.ConclusionsClinically and prognostically relevant interobserver discordance concerning the BGS seems, at least in part, to be attributable to inherent 'aggressive' versus 'reserved' grading characteristics of individual pathologists.Copyright © 2012 S. Karger AG, Basel.

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