Clinicopathological Study of Whipple's Pancreaticoduodenectomy Specimens: A 2-Year Study in a Tertiary Care Cancer Centre
DOI:
https://doi.org/10.21276/apalm.3509Keywords:
Pancreaticoduodenectomy, Whipples Pancreaticoduodenectomy, periampullary tumour, histomorphological variationAbstract
Background: Whipple's Pancreaticoduodenectomy (WPD) is done for a myriad of tumours as well as inflammatory conditions affecting the duodenum, CBD, ampulla of Vater, and head of pancreas. This study aims to analyze the demographic distribution and histomorphological variations of WPD specimens and to evaluate the prognostic significance of these parameters.
Methods: This is a prospective study of 35 WPD specimens received in our department. Details were collected, and gross and microscopic features were analysed and recorded. Slides were reviewed, and the parameters were calculated.
Results: Out of 35 patients, 28 cases (80%) were malignant, 2 cases (5.7%) were tumors with low malignant potential, and 5 cases (14.2%) were benign. The M:F was 1.18:1. The mean age of the patients was 54.7 years. Periampullary carcinomas were the predominant malignant tumors (22.8%), followed by ampullary carcinomas (17.14%). Well-differentiated adenocarcinoma was the most common histology. Most of the tumors were stage T3. Out of 28 malignant tumors, 11 cases had LVI, 11 cases had PNI, and 12 cases showed lymph node metastasis. Only one case had a positive resection margin.
Conclusion: Our study emphasizes the importance of tumour grade, tumour stage, presence of LVI, PNI, positive margins, and lymph node metastasis as strong prognostic factors for patient survival. This is well corroborated by the significant p-value in our study. Most of our cases were diagnosed at a locally advanced stage. Hence, a more precise assessment and clinical evaluation can lead to early detection of cancer, improving survival rates.
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