Pathology Reporting of Resected Pancreatic/Periampullary Cancer Specimen

  • María Carmen Gómez-Mateo
  • Luis Sabater-Ortí
  • Inmaculada Ruiz-Montesinos
  • Antonio Ferrández-Izquierdo


Pancreatic specimens have always been a great challenge for surgical pathologists due to their anatomic complexity and the difficulty of becoming familiar with these specimens. However, pancreatic specimens are becoming more and more common in many hospitals because of the improvements in surgical techniques and perioperative care that have dramatically reduced the postoperative mortality rate.

Pathological aspects are highly relevant for the management of cancer patients. However, in pancreatic cancer the discrepancies in the published data in terms of relevance have obscured their real value. This variability is mainly due to the different pathological approaches, not only in specimen handling and slicing but also in defining what should be considered as “margin” or “surface,” the nomenclature of these margins, and when we should consider that a margin is involved (0 mm versus 1 mm rule).

In the last decade, the use of standardized pathological protocols for macroscopic handling and reporting has proved to be essential for obtaining robust and reproducible data, emphasizing the fact that a good quality pathological report is required because of its prognostic relevance and implications in oncological treatment. However, some disagreements still exist regarding the most important guidelines, and this continues to be an obstacle for homogenizing and comparing studies.


Pancreatic cancer Duodenopancreatectomy Resection margins Pathology protocols 



American Joint Committee on Cancer


Bile duct margin


College of American Pathologists


Cephalic duodenopancreatectomy


Circumferential resection margin


Distal bile duct carcinoma


Distal pancreatectomy


Intraductal papillary mucinous neoplasm


International Study Group of Pancreatic Surgery


Intraductal tubulopapillary neoplasm


Japan Pancreas Society


Lymph node


Lymph node ratio


Pancreatic intraepithelial neoplasia


Pancreatic ductal adenocarcinoma


Pancreatic neck margin


Posterior surface of the uncinate process margin


Portal vein-superior mesenteric vein margin


Royal College of Pathologists of Australasia


Royal College of Pathologists of the United Kingdom


Superior mesenteric artery


Superior mesenteric artery margin


Superior mesenteric vein


Superior mesenteric vein margin


Total pancreatectomy


World Health Organization



The authors thank Ms. Landy Menzies for her review of the manuscript. The authors also thank A. Juaristi, M.J. Silva, M.C. Caballero, and M. Larzabal, specialized pathologists at the Department of Pathology, Hospital Universitario Donostia, for their collaboration.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • María Carmen Gómez-Mateo
    • 1
  • Luis Sabater-Ortí
    • 2
  • Inmaculada Ruiz-Montesinos
    • 3
  • Antonio Ferrández-Izquierdo
    • 4
  1. 1.Department of PathologyHospital Universitario DonostiaDonostiaSpain
  2. 2.Department of SurgeryHospital Clínico, University of ValenciaValenciaSpain
  3. 3.Department of SurgeryHospital Universitario DonostiaDonostiaSpain
  4. 4.Department of PathologyHospital Clínico, University of ValenciaValenciaSpain

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