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Updated: May 27, 2026
Quantification of Tumor Cell Adhesion in Lymph Node Cryosections
Published on: February 9, 2020
Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck
Michiel W M van den Brekel1, Wouter L Lodder, Herbert V Stel
1Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. m.vd.brekel@nki.nl
Background:
Extranodal spread (ENS) of tumors is widely used as a prognosticator for patients with head and neck cancer and is used as an indicator for postoperative treatment. However, the histopathologic agreement among pathologists on the assessment of the presence or absence of this criterion has never been studied.
Methods:
The interobserver and intraobserver agreement among 10 pathologists on the diagnosis of ENS in 41 tumor-positive lymph nodes was evaluated.
Results:
The kappa value of the interobserver agreement among pathologists varied between 0.14 and 0.75, the overall kappa value was 0.42 and 0.49 in the 2 scoring sessions. The intraobserver kappa value varied between 0.49 and 0.95.
Conclusion:
The intraobserver and interobserver agreement among pathologists in the assessment of the presence of ENS was low in metastatic lymph nodes in the neck. Because of the widely accepted prognostic significance and therapeutic consequences of ENS, there is a need for internationally accepted reproducible criterion for the histopathologic assessment of ENS in metastatic lymph nodes in the neck.
