A proposal for improved t-staging of pancreatic ductal adenocarcinoma by using microscopic examination as the basis for determining the size and t-stage

Abstract

Background: Stage remains as the most helpful prognosticator in pancreatic ductal adenocarcinoma (PDAC). However, accurate grossmeasurement of PDAC tumor size, the main stage parameter, is a well-known challenge due to its notoriously ill-defined nature. It hasbeen well documented that there are often satellite microtumor foci beyond the grossly appreciated tumor (PMID: 26832882), which in factmay represent intraparenchymal metastases. This becomes a bigger challenge if the gross room personnel are not experienced enough forthe subtleties of PDAC.