{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:27:28Z","timestamp":1753878448377,"version":"3.41.2"},"reference-count":62,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001785","name":"Flinders University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001785","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The 2021 WHO classification of thoracic tumours recommends grading pleural mesothelioma to aid prognostication. Robustness of grading and morphological characterisation is key to its clinical utility, though validation of this grading system has largely been conducted by expert thoracic pathologists. We conducted a survey inviting pathologists across a range of practices and expertise to grade digitised images of 50 epithelioid pleural mesotheliomas that had been graded by an expert in thoracic pathology. We included slides that were considered potentially problematic such as small biopsies, focal necrosis, and rare subtypes that may affect grading (small cell and deciduoid features). Using the Sectra Uniview web viewer, participants were asked to score atypia, mitotic count, and necrosis and choose from a list of cytological and architectural features. Seventy\u2010four pathologists anonymously participated. There was 90% agreement of consensus scores with expert opinion using the WHO 2\u2010tier grade and 72% for the 3\u2010tier nuclear grade but only 70% for nuclear atypia, 56% for mitoses, and 84% for necrosis. Both 3\u2010tier nuclear grade and WHO 2\u2010tier grading systems were significantly associated with survival. Our study affirms the overall robustness and utility of grading for pleural mesothelioma, reveals variances, and suggests the need for dedicated training.<\/jats:p>","DOI":"10.1111\/apm.70006","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T11:44:02Z","timestamp":1741088642000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Evaluation Into the Robustness of Grading of Pleural Mesothelioma Outside of Specialist Centres"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3252-2519","authenticated-orcid":false,"given":"Sarita","family":"Prabhakaran","sequence":"first","affiliation":[{"name":"Department of Anatomical Pathology Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashleigh J.","family":"Hocking","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazad","family":"Irani","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Hussey","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute  Adelaide South Australia Australia"},{"name":"Department of Anatomical Pathology SA Pathology and Flinders University, Flinders Medical Centre  Bedford Park South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrey","family":"Alexeyenko","sequence":"additional","affiliation":[{"name":"Science for Life Laboratory  Solna Sweden"},{"name":"Evi\u2010Networks Consulting  Huddinge Sweden"},{"name":"Department of Cellular and Molecular Biology Karolinska Institutet  Solna Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katalin","family":"Dobra","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institute  Stockholm Sweden"},{"name":"Department of Clinical Pathology and Cytology Karolinska University Hospital Solna  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tam\u00e1s","family":"Micsik","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institute  Stockholm Sweden"},{"name":"Department of Clinical Pathology and Cytology Karolinska University Hospital Solna  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwina","family":"Duhig","sequence":"additional","affiliation":[{"name":"Sullivan Nicolaides Pathology, Brisbane, Queensland and John Flynn Private Hospital  Tugun Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann E.","family":"Walts","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lieve","family":"Vanwalleghem","sequence":"additional","affiliation":[{"name":"Department of Pathology AZ Sint Jan Bruges  Bruges Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vathana","family":"Chhut","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Health Sciences  Phnom Penh Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja C.","family":"Roden","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine &amp; 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