Survival estimates after pancreatoduodenectomy skewed by non-standardized histopathology reports

Westgaard A, Clausen OPF, Gladhaug IP. Survival estimates after pancreatoduodenectomy skewed by non‐standardized histopathology reports. APMIS 2011; 119: 689–700. Survival estimates may be biased if quality control on histopathology is insufficient. We evaluated the effects of standardizing histopathology for pancreatoduodenectomy specimens and compared survival estimates based on standardized vs non‐standardized histopathological evaluation. Microscopic slides and histopathological reports from 311 consecutive pancreatoduodenectomies (1980–2004) were reviewed, including 104 adenocarcinomas (1980–1997) resected before and 123 adenocarcinomas (1998–2004) resected after standardizing histopathology. Histopathological factors were re‐evaluated for all primary adenocarcinomas (n = 227). The most frequent histological types were pancreatobiliary‐type (n = 145) and intestinal‐type (n = 73). Standardized histopathology was associated with sampling more blocks and nodes (p