膵癌取扱い規約 （英語版）　第4版 Classification of Pancreatic Carcinoma（4th English ed.）

『膵癌取扱い規約 第7版』（2016年7月刊行）の全文英訳版

編　集 Japan Pancreas Society （日本膵臓学会）
定　価 4,400円
（4,000円+税）
発行日 2017/07/10
ISBN 978-4-307-20371-5

B5判・140頁・図数：20枚・カラー図数：127枚

在庫状況 あり
各臓器の癌取扱い規約は我が国における癌の分類・記載法の標準として広く使われているが、これを日本発の情報として海外へ発信するために英語版の刊行が求められた。これに応じ、膵癌では1996年に日本語第4版に準拠した初の英語版が発行され、その後、日本語第5版準拠の第2版が2003年に、日本語第6版準拠の第3版が2011年に刊行された。
本版は『膵癌取扱い規約 第7版』（2016年7月刊行）の全文英訳版である。
Contents

Abbreviations
Synopsis
Dataset for histopathological reports for pancreatic cancer

I. Introduction (purpose and the main disease covered)

II. Principles of Recording Findings

III. Description of Findings
　1. Primary tumor
　　1) Tumor location
　　2) Size and number of the tumors
　　3) Macroscopic type
　　4) Grade of local invasion
　　　(1) T category
　　　(2) Diagnostic imaging guidance for T category
　　　(3) CT imaging evaluating T category (comparison with the microscopic view)
　2. Lymph node metastases
　　1) Identification of the lymph nodes
　　　(1) Station numbers, names, and boundaries of lymph nodes related to the pancreas
　　　(2) Lymph node numbers related to the pancreas and diagnostic CT criteria for lymph node metastasis
　　2) Regional lymph nodes
　　3) Recording lymph node metastases
　　　(1) Degree of lymph node metastasis (N)
　　　(2) Ratio of lymph node metastasis
3. Distant metastases (M)
　1) Peritoneal metastasis (P)
　2) Hepatic metastasis (H)
4. Staging
　TNM Clinical Classification of the UICC TNM Classification, 8th edition (2016)
5. Resectability classification
　1) Resectability
　2) Examples of CT images for resectability classification

IV. Surgical Treatment
　1. Type of operative procedure
　　1) Surgery with or without resection
　　2) Method of operative approach
　2. Description of pancreatic resection
　　1) Type of resection
　　2) Combined resection
　　3) Reconstructions
　　　(1) Reconstructions after PD, PPPD, or SSPPD
　　　(2) Type of pancreaticoenteric anastomosis
3. Classification of lymph node dissections (D)
4. Assessment of residual tumor (R)
　1) Pancreatic cut-end margin (PCM)
　2) Bile duct cut-end margin (BCM)
　3) Dissected peripancreatic tissue margin (DPM)

V. Results of Treatment
　1. Number of patients with pancreatic cancer
　2. Prognostic survey
　3. Cause of death
　4. Mode of recurrence
　5. Survival rate

VI. Handling of Resected Specimens
　1. Handling of resected pancreatic specimens
　2. Sectioning
　　1) Pancreatoduodenectomy specimens
　　2) Distal pancreatectomy specimens
　　3) Total pancreatectomy specimens
　3. Method of performing peritoneal washing cytology

VII. Histological Findings of Pancreatic Neoplasms
　1. International Classification of Diseases for Oncology (ICD-O) code
　　[1] Epithelial neoplasms
　　2] Non-epithelial neoplasms
　2. Cancer-stroma relationship
　3. Growth patterns of neoplasms infiltrating surrounding tissue (INF)
　4. Lymphatic invasion (ly)
　5. Venous invasion (v)
　6. Nerve invasion (ne)
　7. Intraductal spread in MPD (mpd)
　8. Explanation of the histological classification
　　[1] Epithelial neoplasms
　　[2] Non-epithelial neoplasms
■Atlas of Pathology
Exocrine Neoplasms
Serous neoplasms
Mucinous cystic neoplasm
Intraductal neoplasms
Pancreatic intraepithelial neoplasia (PanIN)
Invasive ductal carcinomas
Acinar cell neoplasms
Neuroendocrine Neoplasms
Epithelial Neoplasms of Uncertain Differentiation

VIII. Biopsy/Cytology of Pancreatic Neoplasms
　1. Reporting of pancreatic biopsy/cytology
■Biopsy Histology
　2. Pancreatic cytology report
　　1) Reporting format and diagnosis
　　2) Classification of intraoperative peritoneal washing cytology (CY)
　　3) Pancreatic neoplasms
■Cytological Atlas

IX. Histological Assessment of Preoperative Therapeutic Effects

Criteria for histological response to drug therapy/radiotherapy
Histological findings following drug therapy/radiotherapy
Example of histological assessment of preoperative therapeutic effects (Grade 2)

Preface of the Fourth English Edition

The purpose of establishing cancer classification is to make rules and guidelines so that clinicians and pathologists can compare and discuss collected cancer data and clinical outcomes based on a common criteria. As for the classification of pancreatic cancer in Japan, the 1st Japanese edition of the General Rules for the Study of Pancreatic Cancer was released in 1980 by the Japan Pancreas Society (JPS). The 7th Japanese edition by JPS was published in 2016. During the interval, the English edition had been published: the 1st edition in 1996 as the 4th Japanese edition, the 2nd in 2003 as the 5th and the 3rd in 2011 as the 6th.
The 6th Japanese edition (2009) had been used widely in Japan, together with the Union for International Cancer Control (UICC) 7th edition (2009). Two classifications adopted TNM classification, but they were quite different in T category, N category, and Staging system, constituting obstacles to compare status and clinical outcomes of pancreatic cancer patients between Japan and western countries. Therefore, the revision committee of JPS started its work in April 2013, and the 7th Japanese edition has been published in July 2016. The current revision by JPS focuses on establishing consistency between the Japanese and UICC classifications; however, originality of JPS classification, which is more precise and contains more information, is maintained. In the 7th Japanese edition, major revisions have been carried out by comparing the 6th edition in the following points. (1) Definition of the portions of the pancreas: the border between the pancreatic body and tail is defined as the left side line of the abdominal aorta, (2) T category: consistency with that of the UICC 7th edition, (3) Reappraisal of anatomy of extrapancreatic nerve plexuses, (4) N category: new classification based on numbers of lymph nodal metastasis among the regional lymph nodes, (5) Stage grouping: consistency with UICC 7th staging system, and (6) Histopathological classification: consistency with the World Health Organization (WHO) classification. Furthermore, the following new items have been added: (1) criteria of diagnosis for T category based on multi-detector row computed tomography (MD-CT), (2) criteria of diagnosis for lymph nodal metastasis based on MD-CT, (3) criteria defining resectability, (4) cytopathology guideline, and (5) criteria of histological response to drug therapy and/or radiotherapy. To assist in the dissemination of knowledge in the JPS classification of pancreatic cancer, the 7th Japanese edition is being published here as the fourth English edition. It is our hope that the new JPS classification will contribute to improvement of diagnosis as well as data analysis of pancreatic cancer.

July 2017

Shuji Isaji, MD, PhD
Chairman, Committee on General Rules for the Study of Pancreatic Cancer
Japan Pancreas Society