Two-tier architecture-based grading for pancreatic cancer outperforms traditional grading.

Objectives: A novel architecture-based grading system for pancreatic ductal adenocarcinoma (PDAC) is tested against traditional grading.

Methods: A total of 103 PDAC resections were graded by College of American Pathologists/American Joint Committee on Cancer (CAP/AJCC) guidelines and by a system using an architectural pattern (dispersed larger duct = low grade vs dense smaller duct = high grade). Survival analyses and interobserver variability were assessed.