Inter‐observer variation between pathologists in the classification of cutaneous malignant melanoma in Western Australia

Inter‐observer variation between six pathologists in their application of histological classifications during a survey of cutaneous malignant melanoma was analysed using kappa statistics. The highest levels of adjusted agreement were attained for tumour thickness and the presence of ulceration; intermediate levels were achieved on cross‐sectional profile, level of invasion, histogenetic type, solar elastosis and the presence of an associated benign melanocytic lesion; agreement on other histological features of melanoma tended to be relatively poor. The problems experienced in the interpretation of these classifications are discussed and suggestions for their improvement are offered.

[1]  C. Holman,et al.  Inter‐observer variation in the histopathological reporting of Hodgkin's disease: an analysis of diagnostic subcomponents using kappa statistics , 1983, Histopathology.

[2]  P. Royston,et al.  Prognostic value of tumour thickness in cutaneous malignant melanoma , 1983, Journal of clinical pathology.

[3]  P. Heenan,et al.  Survival from Invasive Cutaneous Malignant Melanoma in Western Australia and the Oxford Region: a Comparative Histological Study of High and Low Incidence Populations , 1983, Pathology.

[4]  C. Balch,et al.  A Comparison of Prognostic Factors and Surgical Results in 1,786 Patients with Localized (Stage I) Melanoma Treated in Alabama, USA, and New South Wales, Australia , 1982, Annals of surgery.

[5]  Heenan Pj,et al.  Nodular malignant melanoma: a distinct entity or a common end stage? , 1982 .

[6]  C. Holman,et al.  An improved method of analysis of observer variation between pathologists , 1982, Histopathology.

[7]  V. McGovern,et al.  Ulceration and prognosis in cutaneous malignant melanoma , 1982, Histopathology.

[8]  M. Mihm,et al.  Prognostic Factors for Patients with Clinical Stage I Melanoma of Intermediate Thickness (1.51–3.99 mm)* A Conceptual Model for Tumor Growth and Metastasis , 1982 .

[9]  M. Mihm,et al.  Prognostic Factors for Melanoma Patients with Lesions 0.76–1.69 mm in Thickness An Appraisal of “Thin” Level IV Lesions , 1982, Annals of surgery.

[10]  C. Holman,et al.  Nodular malignant melanoma: a distinct entity or a common end stage? , 1982, American journal of dermatopathology.

[11]  N. Cascinelli,et al.  Stage I melanoma of the skin: Evaluation of prognosis according to histologic characteristics , 1981, Cancer.

[12]  M. Mihm,et al.  Malignant Melanoma: Prognostic Significance of “Microscopic Satellites” in the Reticular Dermis and Subcutaneous Fat , 1981, Annals of surgery.

[13]  D Ellis,et al.  Hypocomplementemic idiopathic membranous glomerulopathy. , 1981, Human pathology.

[14]  P S Ellis,et al.  Mitosis counting--a need for reappraisal. , 1981, Human pathology.

[15]  R. Prescott,et al.  Cutaneous malignant melanoma in south-east Scotland. , 1981, The Quarterly journal of medicine.

[16]  A. Ackerman.  Malignant melanoma: a unifying concept. , 1980, Human pathology.

[17]  W. Clark,et al.  Dysplastic nevus syndrome: A phenotypic association of sporadic cutaneous melanoma , 1980, Cancer.

[18]  A. Cochran,et al.  Difficulties encountered in the application of clark classification and the Breslow thickness measurement in cutaneous malignant melanoma , 1980, International journal of cancer.

[19]  A. M. Skene,et al.  Observer variation in assessment of liver biopsies including analysis by kappa statistics , 1980 .

[20]  C. Balch,et al.  The prognostic significance of ulceration of cutaneous melanoma , 1980, Cancer.

[21]  V. McGovern,et al.  Is malignant melanoma arising in a Hutchinson's melanotic freckle a separate disease entity? , 1980, Histopathology.

[22]  A. Levene.  On the histological diagnosis and prognosis of malignant melanoma. , 1980, Journal of clinical pathology.

[23]  W. Clark,et al.  The classification of malignant melanoma. , 1980, The American Journal of dermatopathology.

[24]  A. Skene,et al.  Observer variation in assessment of liver biopsies including analysis by kappa statistics. , 1980, Gastroenterology.

[25]  A. Breslow.  Prognosis in cutaneous melanoma: tumor thickness as a guide to treatment. , 1980, Pathology annual.

[26]  S. Orell,et al.  INTERNATIONAL PATHOLOGISTS CONGRUENCE SURVEY ON QUANTITATION OF MALIGNANT MELANOMA , 1980, Pathology.

[27]  R. Sagebiel.  Histopathology of borderline and early malignant melanomas , 1979, The American journal of surgical pathology.

[28]  J. Richard Landis,et al.  Large sample variance of kappa in the case of different sets of raters. , 1979 .

[29]  V. McGovern,et al.  Prognostic significance of the histological features of malignant melanoma , 1979, Histopathology.

[30]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[31]  L. Peterson,et al.  Prognostic factors in cutaneous malignant melanoma in stage I. A clinical, morphological and multivariate analysis. , 1980, Scandinavian journal of plastic and reconstructive surgery.

[32]  C. Balch,et al.  A Multifactorial Analysis of Melanoma: Prognostic Histopathological Features Comparing Clark's and Breslow's Staging Methods , 1978, Annals of surgery.

[33]  M. S. Blois,et al.  The regressing thin malignant melanoma. A distinctive lesion with metastatic potential , 1978, Cancer.

[34]  O. Braun-falco,et al.  Prognostic index in malignant melanoma. , 1978, Archives of dermatology.

[35]  L. Peterson,et al.  Prognostic Factors in Cutaneous Malignant Melanoma in Stage I: A Clinical, Morphological and Multivariate Analysis , 1978 .

[36]  W. Clark,et al.  Comparison of the classification by microscopic level (stage) of malignant melanoma by three independent groups of pathologists , 1977, Cancer.

[37]  A. Breslow.  Tumor Thickness, Level of Invasion and Node Dissection in Stage I Cutaneous Melanoma , 1975, Annals of surgery.

[38]  V. McGovern.  SPONTANEOUS REGRESSION OF MELANOMA , 1975, Pathology.

[39]  W. Clark,et al.  The classification of malignant melanoma and its histologic reporting , 1973, Cancer.

[40]  J. Fleiss.  Measuring nominal scale agreement among many raters. , 1971 .

[41]  A Breslow,et al.  Thickness, Cross‐Sectional Areas and Depth of Invasion in the Prognosis of Cutaneous Melanoma , 1970, Annals of surgery.

[42]  V. McGovern.  The Classification of Melanoma and its Relationship with Prognosis , 1970, Pathology.

[43]  W. Clark,et al.  The histogenesis and biologic behavior of primary human malignant melanomas of the skin. , 1969, Cancer research.