Abstract
The diagnosis of canine soft tissue sarcoma (STS) is based on histological assessment. Assessment of criteria such as, degree of differentiation, necrosis score and mitotic score, gives rise to a final tumour grade, which is important in the recommendation of treatment and prognosis of patients. Previously diagnosed cases of STS were independently assessed by three board-certified veterinary pathologists. Participating pathologists were blinded to the original results. For the intra-observer study, the cases were assessed by a single pathologist six months apart and slides were randomized between readings. For the inter-observer study, the whole case series was assessed by a single pathologist before being passed onto the next pathologist. Intraclass correlation coefficient (ICC) and Fleiss's Kappa (ƙ) for the intra- (single observer) and inter-observer agreement. Strong agreement was observed for the intra-observer assessment in necrosis score, mitotic score, total score and tumour grading (ICC between 0.78 to 0.91). The intra-observer agreement for differentiation score was rated perfect (ICC 1.00). The agreement between pathologists for the diagnosis and grading of canine STS was moderate (ƙ = 0.60 and 0.43 respectively). Histological assessment of canine STS had high reproducibility by an individual pathologist. The agreement of diagnosis and grading of canine STS was moderate between pathologists. Future studies are required to investigate further assessment criteria to improve the specificity of STS diagnosis and the accuracy of the STS grading in dogs.
Highlights
Soft tissue sarcoma (STS) includes a heterogeneous group of mesenchymal neoplasms derived from soft tissues.[1]
Strong agreement was observed for the intra-observer assessment in necrosis score, mitotic score, total score and tumour grading (ICC between 0.78 to 0.91)
The agreement of diagnosis and grading of canine soft tissue sarcoma (STS) was moderate between pathologists
Summary
Soft tissue sarcoma (STS) includes a heterogeneous group of mesenchymal neoplasms derived from soft tissues.[1]. Rates of local recurrence and metastasis are variable, making accurate prognostication in individual cases difficult.[1] Various tumour subtypes such as fibrosarcoma, myxosarcoma, liposarcoma, perivascular wall tumour, and peripheral nerve sheath tumour are included in the STS group.[1] A few studies have described a trend that suggest fibrosarcoma and liposarcoma may carry a worse prognosis than other STS subtypes.[3,4,5] the histological subtype currently has little bearing on the clinical management of these tumours as more studies are needed to confirm and measure differences in prognosis among sufficient numbers of tumours of each subtype.[1] In addition, an accurate identification of the STS subtype frequently relies on a large panel of immunohistochemical markers, including those applied to frozen sections[1], making this practice difficult to be routinely applied in the clinical setting. Assessment of criteria such as, degree of differentiation, necrosis score and mitotic score, gives rise to a final tumour grade, which is important in the recommendation of treatment and prognosis of patients
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