Controversies in Pathology Reporting and Staging

  • Fiona Campbell
  • Caroline Sophie Verbeke
Reference work entry


Following surgery for pancreatic cancer, it is the histopathologist who examines, dissects, and samples the resection specimen for microscopic (histologic) assessment, with the aim of producing a final pathology report that includes all the relevant prognostic information and accurate tumor staging. However, there is no universally agreed pathology protocol for the handling and sampling of pancreatic cancer resection specimens, particularly pancreatoduodenectomy specimens, and pathologists have differing opinions over what is a resection margin and when it should be considered involved. The increasing use of neoadjuvant therapy has also led to new challenges for the pathologist. Differences in interpretation of the TNM staging system can mean that two pathologists stage the same pancreatic cancer resection specimen quite differently. This chapter discusses the pathology reporting and staging of pancreatic cancer resection specimens, with particular emphasis on the challenges and areas of controversy for the pathologist.


Pathology Pancreas Cancer Margin Staging Tumor regression Neoadjuvant therapy 


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Royal Liverpool University HospitalLiverpoolUK
  2. 2.Oslo University HospitalOsloNorway

Section editors and affiliations

  • James L. Abbruzzese
    • 1
  • Raul A. Urrutia
    • 2
  • John Neoptolemos
    • 3
  • Markus W. Büchler
    • 4
  • Thilo Hackert
    • 5
  1. 1.Duke University Medical CenterDurhamUSA
  2. 2.Mayo Clinic Cancer CenterMayo ClinicRochesterUSA
  3. 3.Division of Surgery and OncologyUniversity of LiverpoolLiverpoolUK
  4. 4.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany
  5. 5.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany

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