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
Authors: A. Pulvirenti, A. Pea, N. Rezaee, C. Gasparini, G. Malleo, M. J. Weiss et al.
Impact of postoperative infective complications on long‐term survival after liver resection for hepatocellular carcinoma.
Authors: T. Yang, K. Liu, C.‐F. Liu, Q. Zhong, J. Zhang, J.‐J. Yu et al.
Meta‐analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis.
Authors: N. Moody, A. Adiamah, F. Yanni, D. Gomez
Authors: L. Lundgren, C. Muszynska, A. Ros, G. Persson, O. Gimm, B. Andersson et al.
Meta‐analysis of effect of routine enteral nutrition on postoperative outcomes after pancreatoduodenectomy.
Authors: M. Tanaka, M. Heckler, A. L. Mihaljevic, P. Probst, U. Klaiber, U. Heger et al.
Management of isolated recurrence after surgery for pancreatic adenocarcinoma. BJS 2019; 106: 898-909.
Authors: Y. I. Kim, K. B. Song, Y.‐J. Lee, K.‐M. Park, D. W. Hwang, J. H. Lee et al.
Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial). BJS 2019; 106: 910-921.
Authors: J. van Hilst, E. A. Strating, T. de Rooij, F. Daams, S. Festen, B. Groot Koerkamp et al.
Hepatectomy for hepatocellular carcinoma after perioperative management of portal hypertension. BJS 2019; 106: 1066-1074.
Authors: N. Takemura, T. Aoki, K. Hasegawa, J. Kaneko, J. Arita, N. Akamatsu et al.
Clinical value of additional resection of a margin‐positive distal bile duct in perihilar cholangiocarcinoma. BJS 2019; 106: 774-782.
Authors: S. Otsuka, T. Ebata, Y. Yokoyama, T. Mizuno, T. Tsukahara, Y. Shimoyama et al.
Impact of resection margin status on recurrence and survival in pancreatic cancer surgery. BJS 2019; 106: 1055-1065.
Authors: W. S. Tummers, J. V. Groen, B. G. Sibinga Mulder, A. Farina‐Sarasqueta, J. Morreau, H. Putter et al.
Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation. BJS 2019; 106: 756-764.
Authors: J. Kirkegård, E. K. Aahlin, M. Al‐Saiddi, S. O. Bratlie, M. Coolsen, R. J. de Haas et al.
Outcomes following pancreatic surgery using three different thromboprophylaxis regimens. BJS 2019; 106: 765-773.
Authors: R. G. Hanna‐Sawires, J. V. Groen, F. A. Klok, R. A. E. M. Tollenaar, W. E. Mesker, R. J. Swijnenburg et al.