Validation of at least 1 mm as cut‐off for resection margins for pancreatic adenocarcinoma of the body and tail. BJS 2018; 105: 1171-1181.
Published: 8th May 2018
Authors: T. Hank, U. Hinz, I. Tarantino, J. Kaiser, W. Niesen, F. Bergmann et al.
The definition of resection margin (R) status in pancreatic cancer is under debate. Although a margin of at least 1 mm is an independent predictor of survival after resection for pancreatic head cancer, its relevance to pancreatic body and tail cancers remains unclear. This study aimed to validate R status based on a 1‐mm tumour‐free margin as a prognostic factor for resected adenocarcinoma involving the pancreatic body and tail.
Patients who underwent distal or total pancreatectomy for adenocarcinomas of the pancreatic body and tail between January 2006 and December 2014 were identified from a prospective database. Resection margins were evaluated using a predefined cut‐off of 1 mm. Rates of R0, R1 with invasion within 1 mm of the margin (R1 less than 1 mm), and R1 with direct invasion of the resection margin (R1 direct) were determined, and overall survival in each group assessed by Kaplan–Meier analysis. Univariable and multivariable Cox regression analyses were performed to identify predictors of survival.
R0 resection was achieved in 107 (23·5 per cent) and R1 in 348 (76·5 per cent) of 455 patients. Among R1 resections, invasion within 1 mm of the margin was found in 104 (22·9 per cent) and direct invasion in 244 (53·6 per cent). The R0 rate was 28·9 per cent after distal and 18·6 per cent after total pancreatectomy. In the total cohort, median survival times for patients with R0, R1 (less than 1 mm) and R1 (direct) status were 62·4, 24·6 and 17·2 months respectively, with 5‐year survival rates of 52·6, 16·8 and 13·0 per cent (
A cut‐off of at least 1 mm for evaluation of resection margins is an independent determinant of survival after resection of adenocarcinomas of the pancreatic body and tail.Full text
You may also be interested in
Cost‐effectiveness of liver transplantation in patients with colorectal metastases confined to the liver.
Authors: G. M. W. Bjørnelv, S. Dueland, P.‐D. Line, P. Joranger, Å. A. Fretland, B. Edwin et al.
Notes: Not for every country
Mitochondrial function after associating liver partition and portal vein ligation for staged hepatectomy in an experimental model.
Authors: A. Budai, G. Horváth, L. Tretter, Z. Radák, E. Koltai, Z. Bori et al.
Notes: Defines the biochemical basis
Authors: M. Del Chiaro, K. Søreide
Multicentre study of the prognostic impact of preoperative bodyweight on long‐term prognosis of hepatocellular carcinoma.
Authors: J. J. Yu, F. Shen, T. H. Chen, L. Liang, J. Han, H. Xing et al.
Notes: BMI matters
Authors: G. Marchegiani, S. Andrianello, G. Morbin, E. Secchettin, M. D'Onofrio, R. De Robertis et al.
Notes: Duct dilatation no risk alone
Pancreas‐sparing, ampulla‐preserving duodenectomy for major duodenal (D1–D2) perforations. BJS 2018; 105: 1487-1492.
Authors: S. Di Saverio, E. Segalini, A. Birindelli, S. Todero, M. Podda, A. Rizzuto et al.
Notes: Useful option
Profile of exhaled‐breath volatile organic compounds to diagnose pancreatic cancer. BJS 2018; 105: 1493-1500.
Authors: S. R. Markar, B. Brodie, S.‐T. Chin, A. Romano, D. Spalding, G. B. Hanna et al.
Notes: Breath test for pancreatic cancer
Authors: S. Gasteiger, B. Cardini, G. Göbel, R. Oberhuber, F. Messner, T. Resch et al.
Notes: Good outcome in selected patients
Meta‐analysis of the prognostic role of perioperative platelet count in posthepatectomy liver failure and mortality. BJS 2018; 105: 1254-1261.
Authors: A. Mehrabi, M. Golriz, E. Khajeh, O. Ghamarnejad, P. Probst, H. Fonouni et al.
Notes: Low platelets, worse outcomes
Meta‐analysis of prognostic factors for overall survival in patients with resected hilar cholangiocarcinoma. BJS 2018; 105: 1408-1416.
Authors: N. T. E. Bird, A. McKenna, J. Dodd, G. Poston, R. Jones, H. Malik et al.
Notes: Tumour biology is important
Randomized clinical trial
Randomized clinical trial of stapler hepatectomy versus LigaSure™ transection in elective hepatic resection. BJS 2018; 105: 1119-1127.
Authors: J. Fritzmann, J. Kirchberg, D. Sturm, A. B. Ulrich, P. Knebel, A. Mehrabi et al.
Authors: Y. Kishi, S. Nara, M. Esaki, N. Hiraoka, K. Shimada
Notes: Standardized lymphadenectomy is important