Recommendation for the Examination of Pancreaticoduodenectomy Specimens Removed from Patients with Carcinoma of the Exocrine Pancreas. A Proposal for a Standardized Pathological Staging of Pancreaticoduodenectomy Specimens Including a Checklist

The prognosis of ductal adenocarcinoma of the pancreas is poor. Despite many attempts at a more aggressive surgical approach, tumor recurrence rates of around 80% are common. For various reasons, most of the studies on the subject are difficult to compare. Not only do the surgical techniques vary, but, more importantly, the methods used for processing the specimens and for the pathological examination differ. If we are to improve the situation, it would appear imperative to standardize procedures. Standardized pathological staging of pancreaticoduodenectomy specimens should be performed mainly with reference to the guidelines of the WHO and UICC, with optional staging of the lymph nodes according to their anatomical site. Precise definition and accurate examination of the resection margins, especially of that towards the retroperitoneum, is essential for a better comparison of the results of the different therapeutic strategies and approaches to pancreatic carcinoma.