Can Cutaneous Squamous Cell Carcinoma Be Properly Graded? Investigation of the Differentiation Grading Among Dermatopathologists

• Activity Number: 385 - SPEED: Statistical Methods and Applications in Medical Research, Risk Analysis, and Marketing Part 1
• Type: Contributed
• Date/Time: Wednesday, August 10, 2022 : 8:30 AM to 10:20 AM
• Sponsor: Section on Medical Devices and Diagnostics
• Author(s): Yevgeniya Gokun* and Xueliang Pan and David Carr and Katie Shahwan and Jessica Nash
• Companies: The Ohio State University and The Ohio State University and The Ohio State University and The Ohio State University and The Ohio State University
• Keywords: kappa statistics; reliability; differentiation grading; cutaneous squamous cell carcinoma

Abstract

Poor differentiation is associated with aggressive forms of cutaneous squamous cell carcinoma (CSCC). However, there is a great concern of reliability of the grading differentiation. The exclusion of this differentiation as a CSCC staging criteria is likely due to contradictory studies and insufficient evidence on the reliability of grading differentiation, both within and between raters. The objective of this study is to assess the reliability of CSCC differentiation grading. 21 board-certified dermatopathologists across US were recruited to grade the differentiation of 45 CSCCs before (T0) and after a 6-week washout period (T1). Inter-rater and intra-rater reliability were calculated using the Light’s and Cohen’s kappas, respectively. Only moderate inter-rater (T0 ?=0.53, T1 ?=0.55) and intra-rater (?=0.56) agreement was found, with significant variation among raters. Kappa statistics can be used to evaluate the inter-rater and intra-rater reliability of CSCC differentiation grading. These reliabilities of CSCC differentiation grading by dermatopathologists falls below the acceptable clinical threshold. There is critical need for standardized, validated guidelines.