Original ArticlesTowards 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 GroupDhall, Deepti MD*; Shi, Jiaqi MD, PhD†; Allende, Daniela S. MD‡; Jang, Kee-Taek MD§; Basturk, Olca MD∥; Adsay, Volkan MD¶; Kim, Grace E. MD#Author Information *Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL †Department of Pathology, Rogel Cancer Center, University of Michigan, Ann Arbor, MI ‡Department of Pathology, Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH §Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ∥Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY ¶Department of Pathology and Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey #Department of Pathology, University of California San Francisco, San Francisco, CA D.D. and J.S. are co-first authors. Conflicts of Interest and Source of Funding: J.S. was supported in part by the National Cancer Institute of the National Institutes of Health under award number K08CA234222. For the remaining authors none were declared. Correspondence: Grace E. Kim, MD, Department of Pathology, University of California San Francisco, 1825 4th Street, M2357, Box 4066, San Francisco, CA 94143 (e-mail: [email protected]). The American Journal of Surgical Pathology: October 2021 - Volume 45 - Issue 10 - p 1364-1373 doi: 10.1097/PAS.0000000000001723 Buy SDC Metrics Abstract 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. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.