Pathologic evaluation and reporting of intraductal papillary mucinous neoplasms of the pancreas and other tumoral intraepithelial neoplasms of pancreatobiliary tract

Recommendations of verona consensus meeting

Volkan Adsay, Mari Mino-Kenudson, Toru Furukawa, Olca Basturk, Giuseppe Zamboni, Giovanni Marchegiani, Claudio Bassi, Roberto Salvia, Giuseppe Malleo, Salvatore Paiella, Christopher Wolfgang, Hanno Matthaei, G. Johan Offerhaus, Mustapha Adham, Marco J. Bruno, Michelle D. Reid, Alyssa Krasinskas, Günter Klöppel, Nobuyuki Ohike, Takuma Tajiri & 7 others Kee Taek Jang, Juan Carlos Roa, Peter Allen, Carlos Fernández-Del Castillo, Jin Young Jang, David S. Klimstra, Ralph H Hruban

Research output: Contribution to journalArticle

Abstract

Background: There are no established guidelines for pathologic diagnosis/reporting of intraductal papillary mucinous neoplasms (IPMNs). Design: An international multidisciplinary group, brought together by the Verona Pancreas Group in Italy-2013, was tasked to devise recommendations. Results: (1) Crucial to rule out invasive carcinoma with extensive (if not complete) sampling. (2) Invasive component is to be documented in a full synoptic report including its size, type, grade, and stage. (3) The term "minimally invasive" should be avoided; instead, invasion size with stage and substaging of T1 (1a, b, c; ≤0.5, >0.5-≤1, >1 cm) is to be documented. (4) Largest diameter of the invasion, not the distance from the nearest duct, is to be used. (5) A category of "indeterminate/(suspicious) for invasion" is acceptable for rare cases. (6) The term "malignant" IPMN should be avoided. (7) The highest grade of dysplasia in the non-invasive component is to be documented separately. (8) Lesion size is to be correlated with imaging findings in cysts with rupture. (9) The main duct diameter and, if possible, its involvement are to be documented; however, it is not required to provide main versus branch duct classification in the resected tumor. (10) Subtyping as gastric/intestinal/pancreatobiliary/oncocytic/mixed is of value. (11) Frozen section is to be performed highly selectively, with appreciation of its shortcomings. (12) These principles also apply to other similar tumoral intraepithelial neoplasms (mucinous cystic neoplasms, intra-ampullary, and intrabiliary/cholecystic). Conclusions: These recommendations will ensure proper communication of salient tumor characteristics to the management teams, accurate comparison of data between analyses, and development of more effective management algorithms.

Original languageEnglish (US)
Pages (from-to)162-177
Number of pages16
JournalAnnals of Surgery
Volume263
Issue number1
DOIs
StatePublished - 2016

Fingerprint

Carcinoma in Situ
Pancreatic Neoplasms
Neoplasms
Frozen Sections
Gallbladder
Italy
Cysts
Rupture
Pancreas
Stomach
Guidelines
Carcinoma

Keywords

  • Intraductal
  • IPMN
  • Mucinous
  • Neoplasm
  • Pancreas
  • Papillary

ASJC Scopus subject areas

  • Surgery

Cite this

Pathologic evaluation and reporting of intraductal papillary mucinous neoplasms of the pancreas and other tumoral intraepithelial neoplasms of pancreatobiliary tract : Recommendations of verona consensus meeting. / Adsay, Volkan; Mino-Kenudson, Mari; Furukawa, Toru; Basturk, Olca; Zamboni, Giuseppe; Marchegiani, Giovanni; Bassi, Claudio; Salvia, Roberto; Malleo, Giuseppe; Paiella, Salvatore; Wolfgang, Christopher; Matthaei, Hanno; Offerhaus, G. Johan; Adham, Mustapha; Bruno, Marco J.; Reid, Michelle D.; Krasinskas, Alyssa; Klöppel, Günter; Ohike, Nobuyuki; Tajiri, Takuma; Jang, Kee Taek; Roa, Juan Carlos; Allen, Peter; Fernández-Del Castillo, Carlos; Jang, Jin Young; Klimstra, David S.; Hruban, Ralph H.

In: Annals of Surgery, Vol. 263, No. 1, 2016, p. 162-177.

Research output: Contribution to journalArticle

Adsay, V, Mino-Kenudson, M, Furukawa, T, Basturk, O, Zamboni, G, Marchegiani, G, Bassi, C, Salvia, R, Malleo, G, Paiella, S, Wolfgang, C, Matthaei, H, Offerhaus, GJ, Adham, M, Bruno, MJ, Reid, MD, Krasinskas, A, Klöppel, G, Ohike, N, Tajiri, T, Jang, KT, Roa, JC, Allen, P, Fernández-Del Castillo, C, Jang, JY, Klimstra, DS & Hruban, RH 2016, 'Pathologic evaluation and reporting of intraductal papillary mucinous neoplasms of the pancreas and other tumoral intraepithelial neoplasms of pancreatobiliary tract: Recommendations of verona consensus meeting', Annals of Surgery, vol. 263, no. 1, pp. 162-177. https://doi.org/10.1097/SLA.0000000000001173
Adsay, Volkan ; Mino-Kenudson, Mari ; Furukawa, Toru ; Basturk, Olca ; Zamboni, Giuseppe ; Marchegiani, Giovanni ; Bassi, Claudio ; Salvia, Roberto ; Malleo, Giuseppe ; Paiella, Salvatore ; Wolfgang, Christopher ; Matthaei, Hanno ; Offerhaus, G. Johan ; Adham, Mustapha ; Bruno, Marco J. ; Reid, Michelle D. ; Krasinskas, Alyssa ; Klöppel, Günter ; Ohike, Nobuyuki ; Tajiri, Takuma ; Jang, Kee Taek ; Roa, Juan Carlos ; Allen, Peter ; Fernández-Del Castillo, Carlos ; Jang, Jin Young ; Klimstra, David S. ; Hruban, Ralph H. / Pathologic evaluation and reporting of intraductal papillary mucinous neoplasms of the pancreas and other tumoral intraepithelial neoplasms of pancreatobiliary tract : Recommendations of verona consensus meeting. In: Annals of Surgery. 2016 ; Vol. 263, No. 1. pp. 162-177.
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AU - Adsay, Volkan

AU - Mino-Kenudson, Mari

AU - Furukawa, Toru

AU - Basturk, Olca

AU - Zamboni, Giuseppe

AU - Marchegiani, Giovanni

AU - Bassi, Claudio

AU - Salvia, Roberto

AU - Malleo, Giuseppe

AU - Paiella, Salvatore

AU - Wolfgang, Christopher

AU - Matthaei, Hanno

AU - Offerhaus, G. Johan

AU - Adham, Mustapha

AU - Bruno, Marco J.

AU - Reid, Michelle D.

AU - Krasinskas, Alyssa

AU - Klöppel, Günter

AU - Ohike, Nobuyuki

AU - Tajiri, Takuma

AU - Jang, Kee Taek

AU - Roa, Juan Carlos

AU - Allen, Peter

AU - Fernández-Del Castillo, Carlos

AU - Jang, Jin Young

AU - Klimstra, David S.

AU - Hruban, Ralph H

PY - 2016

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