Prognostic benefits of histological grading and immunohistochemistry in human prostatic carcinoma

In the papers presented in this thesis, we have searched for parameters of prognostic relevance for PC. In general our survey encompasses the study of three putative parameters linked with the biological behavior of PC. Initially we have examined the reproducibility of five conventional histological grading systems currently in use for PC. Histological grading was performed by 5 pathologists with varying experience in both general pathology and pathological aspects of male urogenital oncology. All participants in the study received prior to histological grading the original papers in which the grading methods were explained. None of the grading methods displayed a good interobserver agreement such as measured by statistical evaluation. A reasonable interobserver consensus was reached in the methods based primarily on histological (architectural) criteria in simple grading methods as those designed by Broders and Brawn. Though inconsistent with several reports from the United states, the complex Gleason system showed only a poor consensus among the 5 observers.