Clinical utility of pathology data: prostate and kidney cancer

Cancer pathology reports can be complex due to multiple data elements, variability in terminology, and increasing recognition of emerging diagnostic entities. However, treatment may be significantly influenced by histologic subtype, histologic grade, and pathologic tumor stage. We review the clinical utility of pathology data for prostate and kidney cancers, with emphasis on main decision-making points. Key parameters that affect management of prostate cancer in the biopsy setting include Grade Group, percentage of pattern 4, and sometimes extent of involvement. Histologic subtypes mostly do not affect management, with exceptions of small cell carcinoma and sometimes cribriform/intraductal carcinoma. For renal cancer, histologic subtype, tumor grade, and tumor stage are important for prognostication. Confirming a diagnosis of renal cell carcinoma and recognition of clear cell, non-clear cell, and select other histologies are important in the metastatic setting for treatment selection.