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Erschienen in: Virchows Archiv 3/2018

08.08.2018 | Original Article

Tumour origin and R1 rates in pancreatic resections: towards consilience in pathology reporting

verfasst von: Munita Bal, Swapnil Rane, Sanjay Talole, Mukta Ramadwar, Kedar Deodhar, Prachi Patil, Mahesh Goel, Shailesh Shrikhande

Erschienen in: Virchows Archiv | Ausgabe 3/2018

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Abstract

To evaluate differences in the R1 rates of ampullary (AC), pancreatic (PC), and distal bile duct (DBD) cancers in pancreatoduodenectomies (PD) using standardised pathology assessment. Data of PD (2010–2011) analysed in accordance with the Royal College of Pathologists (UK) protocol, were retrieved. Clinicopathologic features, including frequency, topography, and mode of margin involvement in AC (n = 87), PC (n = 18), and DBD (n = 5) cancers were evaluated. The R1 rate was 7%, 67%, and 20% in the AC, PC, and DBD cancers (p < 0.001). Within the PC cohort, R1 rate was heterogeneous (chemo-naïve, 77%; post-neoadjuvant, 40%). Commonest involved margins were as follows: posterior in overall PD (35%), AC (43%), overall PC (33%), and post-neoadjuvant PC (100%); superior mesenteric artery margin in chemo-naïve PC (38%) and common bile duct margin in DBD (100%) cancers. In AC, majority (66%) of R1 were signet ring cell type. Indirect margin involvement due to tumour within lymph node, perineural sheath or lymphovascular space was observed in 26% cases, and altered R1 rate in AC, PC, and DBD cohorts by 1%, 12%, and 0%, respectively. Although not statistically significant, patients with R1 had lower disease-free survival than those with R0 (mean, 25.4 months versus 44.4 months). Tumour origin impacts R1 data in PD necessitating its accurate classification by pathologists. Indirect involvement, histology, and neoadjuvant therapy influence the R1 rate, albeit in a minority of cases. Generating cogent R1 data based on standardised pathology reporting is the foremost need of the hour.
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Metadaten
Titel
Tumour origin and R1 rates in pancreatic resections: towards consilience in pathology reporting
verfasst von
Munita Bal
Swapnil Rane
Sanjay Talole
Mukta Ramadwar
Kedar Deodhar
Prachi Patil
Mahesh Goel
Shailesh Shrikhande
Publikationsdatum
08.08.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Virchows Archiv / Ausgabe 3/2018
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-018-2429-7

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