Abstract
Histopathologic reporting after pancreatoduodenectomy is often non-standardised. Inappropriate reporting may bias survival estimates and make comparison between institutions difficult. Using population-based nationwide data from the Cancer Registry of Norway, we examined the influence on survival estimates of standardised histopathologic reporting versus non-standardised histopathologic reporting after pancreatoduodenectomy for adenocarcinomas in the pancreas, distal bile duct, ampulla and duodenum ( n = 506). Standardised histopathologic reports from a study hospital ( n = 113) were compared with reports from all other institutions (24 hospitals; n = 393) discriminating between high/medium-volume and low-volume institutions. In the study hospital, more tissue blocks were sampled, more nodes were evaluated, and more details about resection margins, size, origin and vascular and perineural infiltration were reported ( p < 0.001). Multivariable survival analysis identified lymph node involvement as the factor that is most dependent on standardised reporting to discriminate between favourable and poor prognostic subgroups ( p = 0.018). Standardised evaluation was more important than hospital volume for completeness of histopathologic reporting and for accuracy of survival estimates.
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