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Annual ISUP Report December 2016

22 December 2016 

ANNUAL PRESIDENT’S REPORT

Dear ISUP member,

This report outlines the achievements of the ISUP during 2016 and details some of our plans for the near future. There has been considerable activity behind the scenes during the autumn and the ISUP Officers and many members have done a great deal of work during 2016 advancing several Society sponsored projects.

ISUP Activities during 2016

  1. ISUP Membership

We are pleased to announce that the ISUP has grown very rapidly the past year. In 2015 the ISUP had 611 members, but has now increased to a staggering 1502 members. This is largely due to our new website, which facilitates registration of new members. The ISUP leadership has also been very active lecturing around the world and utilize every opportunity opportunity to advertise the benefits of ISUP membership. ISUP currently has members in as many as 71 countries and is truly international.

  1. ISUP Website

The new ISUP website was launched a year ago, in December 2015, and has been further developed during 2016 with the help of Jonas Hörnblad. This project continues to be fully financed by grants from Stockholm and no member dues have been used to fund website development.

Website activity is monitored closely and in the first year there have been an impressive 124 000 page views and 6940 unique visitors. These numbers are remarkably high when compared to the total number of pathologists in the world. The normal number of visitors on a weekday is around 50 and there has been an increasing trend during the autumn. Users from as many as 122 countries have visited us and this is obviously a very efficient way of reaching out to our colleagues. As you are probably aware we also have a mobile version of both the ISUP website and Imagebase, which is important for connectivity to remote countries and centers.

For the last two months we have had a new webmaster. Dr Sean Williamson of Henry Ford Health System, Detroit (sean.williamson@temple.edu) has generously agreed to take on this task and it is appropriate that I express the thanks of the Society for his willingness to take on this important component of our operations.

The Upcoming events page on the ISUP website has recently been up-dated and this is a useful resource providing an overview of future international meetings. The site contains a summary of major meetings and the venues where they will take place over the next few years. More detailed information is provided of the more recent meetings and their respective uropathology programs.

One of the new features of the website is that the Case of The Month (COTM) now has an interactive element. If you wish, you can vote for a diagnosis from a multiple-choice list before seeing the diagnosis of the author. The new function is that once you have voted a bar chart will be displayed showing the distribution of votes by other ISUP members. It is also possible to examine the case without voting, if this is preferred. The COTM cases are now formatted as JPEGS and also by a link to a digitized slide. Choose your preferred method! The cases are also ordered in a consecutive list sorted according to month of submission. displayed by thumbnails of each are displayed as an overview so one can easily go back and review old cases. The COTM is maintained by the COTM Editor, Dr Andy Evans. If you have cases that you think may be of interest, please do not hesitate to contact him.

  1. Pathology Imagebase

One of the main achievements of the ISUP during 2016 was the establishment of the ISUP Pathology Imagebase. This is a reference image database for standardization of pathology utilizing collections of images that have been built through independent voting by leading international experts. The project has been entirely financed by grants from the Karolinska University Hospital and The Cancer Society of Stockholm and no membership dues have been used. I am advised that many members frequently use examples from the database for lectures and also for tests when during teaching courses courses. The illustrations are also used in daily practice, when there is a need to calibrate grading and review unusual cases. Please feel free to use the images as you wish but we would ask that you give appropriate credit to the ISUP Imagebase.

A free version of Imagebase was launched during the autumn. This is a “light” version with a limited number of cases (a total of 46 selected consensus cases across five projects) without search functions. The purpose is to showcase ISUP activities and to provide standard illustrations for general pathologists and for pathologists in low resource countries, where membership of a Society may not always be feasible. To reach the free version, go to our website without logging in and click on the Imagebase tab.

Please feel free to disseminate information regarding the free Imagebase outside the ISUP membership. The link is through http://www.isupweb.org or directly to Imagebase at http://isupweb.org/pib-start/.

  1. ISUP Education Project

An educational project aimed at international standardization of urological pathology reporting was initiated by ISUP in 2016. The first target was prostate biopsy pathology as the increasing global incidence of prostate cancer exposes pathologists in former low incidence countries to new challenges. The project may later be extended to other fields of uropathology once the mechanism has been tested and evaluated. It is planned that the ISUP training program is offered for free to pathologists in countries that have made the leap into industrialized economies during the past decades. It is clear that the ISUP will have an important role in promoting the transfer of information to communities that, in some cases, have had little exposure to international teaching.

A web-based mechanism for training and for the evaluation of the efficiency of the program was set up earlier this year. A series of lectures on how to diagnose prostate cancer on needle biopsy was delivered to 12 institutions in 9 countries in South America and South East Asia, consisting of 5 upper middle, 2 lower middle and 2 low resource countries. All prostate lectures were given by the President and in addition, an ISUP consultation course that included bladder and renal tumor pathology was convened together with Hema Samaratunga and Brett Delahunt in Sri Lanka. The diagnostic skills of the participants were tested through an image-based web test both before and after the educational activity. A web-based slide show was also offered between the tests; however this was only available after the completion of Test 1. The first test was closed prior to the delivery of the lectures and Test 2 was only available for view after the completion of the lecture series. After completing Test 2 the participants were able to log in and review their own results together with the images and correct answers. A feedback document including an analysis of replies received and descriptions of the cases utilized has been sent to the each of the participants.

The total number of attendees at the lectures was 754, while 387 and 224 pathologists or residents/trainees in pathology completed Test 1 and 2, respectively. Grouping of the diagnoses into benign, cancer, HGPIN and IDC, from those who completed both tests showed that a correct classification of the biopsies was rendered in 60.7% and 72.3% respectively for Tests 1 and 2, signifying a mean improvement of 11.6% units. Interestingly, the greatest improvement was achieved in low resource countries. It needs to be emphasized that these numbers do not translate into performance in clinical practice as the test cases were more difficult than those usual encountered during routine reporting. The results, however, do provide a guide as to the efficiency of the training system.

The follow-up phase of the project is a purely web-based training platform, again with testing before and after training. The purpose is to compare this form of training against that of formal lectures in order to determine if the training is similar or superior to that of traditional lectures. This platform can be reached at http://education.isupweb.org. First, register as user on the website. If you wish, you can use a nickname but make sure that you enter a valid email address and please fill out the other demographic fields. You will be able to login using your email address and password. The next thing to do is to take Test 1. Once this has been completed, access will be gained to a self-explainatory slide show with simple statements, arrows and asterisks that should be possible to understand even for pathologists with limited knowledge of English. We also intend to translate the slideshow to other languages such as Mandarin, Japanese and Spanish. After the slideshow the user will be asked to complete Test 2 which is identical with Test 1. When Test 2 is finished the correct replies are shown together with a summary of the performance on the both tests.

We hope that this will be a cost effective way of disseminating uropathology knowledge throughout the world with the help of modern interactive media. The project may gradually be extended to other fields of uropathology. The system has been set up by Jonas Hörnblad who also constructed the Imagebase system and major parts of the Society website and all costs have been covered by a research grant from the Stockholm Cancer Society. Please feel free to distribute this information outside the ISUP membership including the link: http://education.isupweb.org.

  1. ISUP Expert Consultation on Testicular and Penile Tumors at USCAP, Boston

At the 2015 USCAP meeting in Boston ISUP hosted an expert consultation conference on testicular and penile tumors. The proceedings from the meeting have now started to be published. Two articles have already been published in Histopathology:

Idrees MT, Ulbright TM, Oliva E, Young RH, Montironi R, Egevad L, Berney D, Srigley JR, Epstein JI, Tickoo SK DM and Members of the ISUP Testicular Tumour Panel. The WHO 2016 Classification of Testicular Non-Germ Cell Tumours: A Review and Update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. On line 2016 Nov 1.

Williamson SR, Delahunt B, Magi-Galluzzi C, Algaba F, Egevad L, Ulbright TM, Tickoo SK, Srigley JR, Epstein JI, Berney DM and Members of the ISUP Testicular Tumour Panel. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. On line 2016 Oct 17.

In addition, a manuscript on Microscopic Features in Testicular Germ Cell Tumours with Clare Verrill as first author has been submitted to Am J Surg Pathol and another manuscript on Reporting and Staging of Testicular Germ Cell Tumors is soon ready for submission.

  1. President-Elect 

As previously informed, our President-Elect stepped down from the post earlier this year. According to Article 2.4 of the By-Laws of the Society, an office that becomes vacant due to resignation is to be filled by resolution of the Council. Dr John Cheville, Mayo Clinic, Rochester, was nominated by Council by unanimous resolution and we are very pleased to announce that he has agreed to accept this appointment.

  1. ESP/IAP Meeting in Cologne

The major pathology event of year was the International Academy of Pathology (IAP) International Congress, which was held in conjunction with the Annual European Society of Pathology (ESP) meeting in Cologne from 25 – 29 September 2016. The scientific program of the meeting had a wide diversity of genitourinary pathology-related activities. Among other activities there was a long course on Advances in Pathology of Prostate Cancer and Renal Cell Carcinoma (Kristiansen, Algaba, Martignoni, Osunkoya, Fleming), a Symposium on the newly released 2016 WHO Classification (Humphrey, Moch, Reuter, Berney, Cubilla) and further Symposium on The Basic Report in Uropathology (ESP/ICCR) (Srigley, Egevad, Grignon, Delahunt, Compérat). The meeting was well attended, which is probably a reflection of it being a combined IAP and ESP event. A highly successful Grawitz dinner was organized by our local host, Prof. Glen Kristiansen.

  1. International Collaboration on Cancer Reporting (ICCR)

ICCR is leading a project that aims to provide a minimum dataset for the reporting of urological pathology. Datasets have been prepared for 12 specimen types in GU pathology: prostate (core biopsies, TURP, RP), urothelial tract (biopsy/TUR, cystectomy, urethrectomy, upper tract), kidney (nephrectomy, core biopsy), testis (orchidectomy, RPLND) and penis. The documents aim to define a minimum level of reporting that would be accepted in different jurisdictions and to provide for uniformity of reporting. Documents and additional information regarding the ICCR will be available on http://www.iccr-cancer.org once they are finalized. The datasets have been prepared by expert panels involving many members of the Society. ISUP Officers and members have been heavily involved in the leadership of ICCR and in co-ordinating expert panels. The resulting documents have undergone open consultation among members of ISUP and other organizations and only minimal adjustments remain to be completed before publication. 

  1. Revision of the ISUP Constitution and By-Laws

Last time ISUP reviewed its Constitution and By-Laws was in 2010 when the revision was endorsed by a 98.6% majority in an electronic vote. A by-laws committee under the lead of Cristina Magi-Galluzzi was appointed in 2015 and delivered its recommendations to the Council in 2016 in draft form. The committee recommendations are now being incorporated into the Constitution and By-Laws documents and our aim is that the proposal will be submitted for an electronic vote among the members before the next AGM in San Antonio.  

  1. ISUP Jubilee Lectureship 

It has been decided that in celebration of the 25th anniversary of the Society that the ISUP Jubilee Lectureship be established. This will be funded to the level of USD 5,000 annually for travelling expenses and the lecturer will be required to give three presentations in the name of the ISUP. The recipient of the first award will be announced at the ISUP Companion Meeting in San Antonio. 

Plans for 2017

  1. USCAP in San Antonio 4-10 March 2017 
  1. ISUP Member Reception The members reception will be held on Saturday 4 March, 4:00-6:00 pm (Rivercenter Salon K, 3rd Floor). The reception will have some additional activities to celebrate the 25th anniversary of the Society. A special guest speaker has been invited to give an oration over the history of uropathology and the early development of our Society. Interesting historical photographs are promised! I am afraid it will become painfully apparent how many of us have aged over this period. Similar to the Seattle reception, this year’s reception will also be fully sponsored by a generous donation from Aquesta Uropathology, Australia, courtesy of the Society’s Secretary, Prof. Hemamali Samaratunga. Do not miss this event! 
  2. ISUP AGM Meeting The Annual General Meeting of ISUP will take place on Saturday 4 March, 6:15-6:45 p.m. in the same room as the ISUP Companion Meeting (starting at 7:00 p.m.) and is open for all members. We attempted to get a room separate from the Companion Meeting so to avoid the stream of non-members entering the auditorium but this was unfortunately not possible. We will try to finish before 6:45 and encourage members to be seated near the front of the room.
  3. ISUP Companion Meeting The ISUP companion meeting will as usual take place on Saturday evening 7:00-10:00 p.m. and will be chaired by Michelle Hirsch and Steven Shen. Topic: The new TNM classification. Speakers: Amin (overview of AJCC TNM), Paner (bladder), Trpkov (kidney), Fine (prostate), Idrees (testis) and Tamboli (penis).
  4. No ISUP Consensus Meeting in 2017 ISUP has hosted a large number of consensus conferences over the past decade, usually in conjunction with the USCAP meetings. We had planned to hold a meeting on bladder cancer in line with the results of a poll among members. There is, however, a certain reluctance from USCAP to let us conduct these activities too frequently as they are seen as competing with the formal USCAP program. We have, therefore, decided not to have any additional ISUP event on Sunday 5 March at this meeting. The GU evening conference is scheduled on Sunday.
  5. Grawitz Dinner The Grawitz Dinner for 2017 will be organized by Mahul Amin and Tom Wheeler. The dinner is scheduled for the evening of Monday 6 March. Time and location to be announced. More detailed information will follow. As usual we will pay for the dinner ourselves and membership of ISUP is not required for those attending. Thus, you can bring spouses, colleagues or friends. As the space is limited, it is necessary that everyone signs up in advance. Information about how to do this will be circulated a couple of weeks before USCAP.
  1. Websites

Further development of the Society websites is planned. More work will be done on the education platform, including translation to other languages and probably also organization of new topics. We may also set up new projects in Imagebase, relating to staging and other tumor classifications.

Another function that needs to be developed is a fully automatic handling of the rapidly expanding membership. With more than 1500 members we can no longer manage member dues manually. The Treasurer, Dr Ming Zhou has just relocated to UT Southwestern Medical Center in Dallas (Ming.Zhou@UTSouthwestern.edu). His personal assistant Britnique Smith (britnique.smith@utsouthwestern.edu) has been recruited to help us with the technical management of our membership until we have a fully automatic system up and running. You might be contacted with reminders to pay the dues. We hope you find your ISUP membership and the services we provide useful in your profession activities and worth the membership dues! 

  1. ISUP Presence at Upcoming Meetings

Meetings in 2017 are listed under Upcoming events on the ISUP website.

The European Society of Pathology meeting will take place in Amsterdam in 2017. At this point we have no information about ISUP activities in the program. At the APIAP meeting in Bali in 2017 the ISUP has no formal presence either, while Dr Egevad will present at the Japanese Society of Pathology (JSP) annual meeting in Tokyo 27-29 April.

  1. New ISUP Leadership

At the AGM in San Antonio we are scheduled to hand over the leadership of ISUP to the President-Elect, Dr John Cheville. I am truly excited to see him at the helm of our Society. I wish him a warm welcome to this role and all the best for his term as President of ISUP. I look forward to seeing his plans for the Society and will be happy to assist whenever requested. I also hope and trust that he and his team will get a whole-hearted support from all of us! Society work is a very time-consuming voluntary activity with no remuneration at all and very little glamor. All the colleagues who are willing to be actively involved should have our endorsement and encouragement.

Finally, we would like to thank you all for your support of ISUP! We hope you will find your membership increasingly useful during 2017. See soon you in San Antonio!

 

Lars Egevad

President of ISUP