Complex glandular pattern is an aggressive morphology that predicts poor prognosis of pancreatic ductal adenocarcinoma

Siegel, 2021, Cancer statistics, 2021, CA Cancer J Clin, 71, 7, 10.3322/caac.21654 2019, vol.3 Dong, 2013, Architectual heterogeneity and cribriform pattern predict adverse clinical outcome for Gleason grade 4 prostatic adenocarcinoma, Am J Surg Pathol, 37, 1855, 10.1097/PAS.0b013e3182a02169 Kir, 2014, The association of the cribriform pattern with outcome for prostatic adenocarcinomas, Pathol Res Pract, 210, 640, 10.1016/j.prp.2014.06.002 Lino-Silva, 2015, Colon cribriform carcinoma, a morphologic pattern associated with low survival, Int J Surg Pathol, 23, 13, 10.1177/1066896914542125 Kadota, 2014, The cribriform pattern identifies a subset of acinar predominant tumors with poor prognosis in patients with stage I lung adenocarcinoma: a conceptual proposal to classify cribriform predominant tumors as a distinct histologic subtype, Mod Pathol, 27, 690, 10.1038/modpathol.2013.188 Adsay, 2005, A proposal for a new and more practical grading scheme for pancreatic ductal adenocarcinoma, Am J Surg Pathol, 29, 724, 10.1097/01.pas.0000163360.40357.f1 Schlitter, 2017, Molecular, morphological and survival analysis of 177 resected pancreatic ductal adenocarcinomas (PDACs): identification of prognostic subtypes, Sci Rep, 7, 41064, 10.1038/srep41064 Kalimuthu, 2020, Morphological classification of pancreatic ductal adenocarcinoma that predicts molecular subtypes and correlates with clinical outcome, Gut, 69, 317, 10.1136/gutjnl-2019-318217 Wang, 2014, Interobserver reproducibility study of the histological patterns of primary lung adenocarcinoma with emphasis on a more complex glandular pattern distinct from the typical acinar pattern, Int J Surg Pathol, 22, 149, 10.1177/1066896913519165 Kuang, 2018, Clinical significance of complex glandular patterns in lung adenocarcinoma: clinicopathologic and molecular study in large series of cases, Am J Clin Pathol, 150, 65, 10.1093/ajcp/aqy032 Moreira, 2020, A grading system for invasive pulmonary adenocarcinoma: a proposal from the International Association for the Study of Lung Cancer Pathology Committee, J Thorac Oncol, 15, 1599, 10.1016/j.jtho.2020.06.001 2021 Hutchings, 2018, Cancerization of the pancreatic ducts: demonstration of a common and under-recognized process using immunolabeling of paired duct lesions and invasive pancreatic ductal adenocarcinoma for p53 and Smad4 expression, Am J Surg Pathol, 42, 1556, 10.1097/PAS.0000000000001148 Fujikura, 2020, Intraductal pancreatic cancer is less responsive than cancer in the stroma to neoadjuvant chemotherapy, Mod Pathol, 33, 2026, 10.1038/s41379-020-0572-6 Lugli, 2017, Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016, Mod Pathol, 30, 1299, 10.1038/modpathol.2017.46 Collisson, 2011, Subtypes of pancreatic ductal adenocarcinoma and their differing responses to therapy, Nat Med, 17, 500, 10.1038/nm.2344 Muckenhuber, 2018, Pancreatic ductal adenocarcinoma subtypes using the biomarkers hepatocyte nuclear factor-1A and cytokeratin-81 correlates with outcome and treatment response, Clin Cancer Res, 24, 351, 10.1158/1078-0432.CCR-17-2180 Mitsunaga, 2006, Important prognostic histological parameters for patients with invasive ductal carcinoma of the pancreas, Cancer Sci, 96, 858, 10.1111/j.1349-7006.2005.00128.x Ozaki, 1999, The prognostic significance of lymph node metastasis and intrapancreatic perineural invasion in pancreatic cancer after curative resection, Surg Today, 29, 16, 10.1007/BF02482964 Hong, 2012, Vascular invasion in infiltrating ductal adenocarcinoma of the pancreas can mimic pancreatic intraepithelial neoplasia: a histopathologic study of 209 cases, Am J Surg Pathol, 36, 235, 10.1097/PAS.0b013e3182376e36 O'Connor, 2015, Tumor budding is an independent adverse prognostic factor in pancreatic ductal adenocarcinoma, Am J Surg Pathol, 39, 472, 10.1097/PAS.0000000000000333 Petrova, 2020, Tumor budding as a prognostic factor in pancreatic ductal adenocarcinoma, Virchows Arch, 476, 561, 10.1007/s00428-019-02719-1 Strobel, 2017, Pancreatic cancer surgery: the new R-status counts, Ann Surg, 265, 565, 10.1097/SLA.0000000000001731 Dursun, 2010, Vacuolated cell pattern of pancreatobiliary adenocarcinoma: a clinicopathological analysis of 24 cases of a poorly recognized distinctive morphologic variant important in the differential diagnosis, Virchows Arch, 457, 643, 10.1007/s00428-010-0978-5 Moffitt, 2015, Virtual microdissection identifies distinct tumor- and stroma-specific subtypes of pancreatic ductal adenocarcinoma, Nat Genet, 47, 1168, 10.1038/ng.3398 Bailey, 2016, Genomic analyses identify molecular subtypes of pancreatic cancer, Nature, 531, 47, 10.1038/nature16965 Puleo, 2018, Stratification of pancreatic ductal adenocarcinomas based on tumor and microenvironment features, Gastroenterology, 155, 1999, 10.1053/j.gastro.2018.08.033 2017, Integrated genomic characterization of pancreatic ductal adenocarcinoma, Cancer Cell, 32, 185, 10.1016/j.ccell.2017.07.007 Noll, 2016, CYP3A5 mediated basal and acquired therapy resistance in different subtypes of pancreatic ductal adenocarcinoma, Nat Med, 22, 278, 10.1038/nm.4038