In this issue of The Journal of Urology® 2 groups address the benefits of and need for review of pathological material from patients referred to a tertiary care medical center from outside health care institutions. Kuroiwa et al (page 952) compared their central review of radical prostatectomy data with those at the 50 referring institutions. Although exact concordance of Gleason score on the radical prostatectomy specimen was only slightly greater than the flip of a coin, results were better for pathological staging data, including the presence or absence of extracapsular extension, seminal vesicle invasion, lymph node involvement and positive surgical margins. Notably high volume institutions had a higher rate of concordance with central review than low volume institutions.
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