Towards a More Standardized Approach to Pathologic Reporting of Pancreatoduodenectomy Specimens for Pancreatic Ductal Adenocarcinoma: Cross-continental and Cross-specialty Survey From the Pancreatobiliary Pathology Society Grossing Working Group.
Towards a More Standardized Approach to Pathologic Reporting of Pancreatoduodenectomy Specimens for Pancreatic Ductal Adenocarcinoma: Cross-continental and Cross-specialty Survey From the Pancreatobiliary Pathology Society Grossing Working Group.
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DOI：
10.1097/pas.0000000000001723
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发表时间：
2021-10-01
期刊：
影响因子：
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通讯作者：
Kim GE
中科院分区：
文献类型：
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作者：
Dhall D;Shi J;Allende DS;Jang KT;Basturk O;Adsay V;Kim GE
在最近举行的文献和国际会议中，很明显，关于切缘的定义以及如何最好地记录胰腺导管腺癌的病理结果存在显着差异。为了了解当前的实践，胰胆病理学会 (PBPS) Grossing 工作组进行了一项国际多专业调查，其中包含 25 项声明，涉及胰腺导管腺癌的病理检查和报告，特别是胰十二指肠切除术标本。调查结果凸显了一些不一致之处；然而，在以下方面达成了共识/高度一致性：1）胰颈边缘应完全正面提交，如果载玻片上有肿瘤，则认为相当于R1； 2）应提交完整的钩缘垂直切片，并报告肿瘤距钩缘的距离； 3) 应检查并记录所有其他表面（包括血管沟、后表面和前表面）； 4) 涉及单独提交的腹腔轴标本的癌症应分期为 pT4。尽管对于 R1 与 R0 的构成尚未达成共识，但大多数参与者一致认为，肿瘤上或距肿瘤 1 毫米以内的墨水仅在指定为边缘而非表面的区域相当于 R1。总之，这项调查提高了人们对不一致的认识，并作为胰十二指肠切除术总体和报告方案进一步标准化的起点。
In recent literature and international meetings held, it has become clear that there are significant differences regarding the definition of what constitutes as margins and how best to document the pathologic findings in pancreatic ductal adenocarcinoma. To capture the current practice, Pancreatobiliary Pathology Society (PBPS) Grossing Working Group conducted an international multispecialty survey encompassing 25 statements, regarding pathologic examination and reporting of pancreatic ductal adenocarcinoma, particularly in pancreatoduodenectomy specimens. The survey results highlighted several discordances; however, consensus/high concordance was reached for the following: 1) the pancreatic neck margin should be entirely submitted en face, and if tumor on the slide, then it is considered equivalent to R1; 2) uncinate margin should be submitted entirely and perpendicularly sectioned, and tumor distance from the uncinate margin should be reported; 3) all other surfaces (including vascular groove, posterior surface, and anterior surface) should be examined and documented; 4) carcinoma involving separately submitted celiac axis specimen should be staged as pT4. Although no consensus was achieved regarding what constitutes R1 versus R0, most participants agreed that ink on tumor or at and within 1 mm to the tumor is equivalent to R1 only in areas designated as a margin, not surface. In conclusion, this survey raises the awareness of the discordances and serves as a starting point towards further standardization of the pancreatoduodenectomy grossing and reporting protocols.