Related Experiment Video
Updated: Aug 15, 2025
10:38
DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
Published on: February 1, 2020
7.5K
"Infiltrative" Versus "Mass-Forming" Pancreatic Cancer: A New Radiological Classification System for Pancreatic Head
Muhammad B Darwish1, Shankar Logarajah1, Patrick J McLaren1
1Department of Surgery, Methodist Richardson Medical Center, Richardson, Texas, USA.
Journal of Pancreatic Cancer
|December 30, 2022
Summary
Radiological imaging can differentiate pancreatic ductal adenocarcinoma (PDAC) into mass-forming and infiltrative types. Infiltrative PDAC shows a trend towards higher positive resection margins, suggesting a need for tailored neoadjuvant therapy.
Area of Science:
- Oncology
- Radiology
- Surgical Pathology
Background:
- Resectability of pancreatic ductal adenocarcinoma (PDAC) is determined by radiological criteria.
- However, ill-defined tumor borders can lead to more extensive cancer than initially predicted.
- This discrepancy impacts surgical outcomes and treatment planning.
Purpose of the Study:
- To radiologically categorize PDAC into "infiltrative" and "mass-forming" types.
- To assess the correlation between these radiological classifications and surgical oncological outcomes.
- To determine if mass-forming lesions correlate with fewer positive resection margins.
Main Methods:
- Retrospective review of 54 patients with PDAC who underwent curative resection (2016-2018).
- Computed tomography images were analyzed by two radiologists.
- Tumors were classified as "mass-forming" or "infiltrative" using a novel system and correlated with margin status.
Main Results:
- Mass-forming lesions showed a trend towards lower positive resection margins (35.7% vs. 50.0%, p=0.18).
- Mass-forming PDAC was associated with significantly larger tumor size (4.03 cm vs. 3.25 cm, p=0.02).
- Infiltrative lesions trended towards higher rates of positive margins.
Conclusions:
- A new radiological classification of PDAC into "mass-forming" and "infiltrative" is proposed.
- Infiltrative PDAC may benefit from neoadjuvant therapy even when appearing resectable.
- This classification aids in refining treatment strategies for PDAC.
