Prognostic significance of involvement of the circumferential resection margin/surface in patients with pancreatic head cancer: A prospective evaluation of pancreatoduodenectomy specimens using the 0 and 1 mm rules

The prognostic significance of circumferential resection margin (CRM) or circumferential surface (CS) in pancreatic head cancer is controversial. We investigated the survival outcomes according to CRM or CS involvement in pancreatoduodenectomy specimens of pancreatic ductal adenocarcinoma (PDAC). A...

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Bibliographic Details
Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2024-11, Vol.24 (7), p.1040-1048
Main Authors: Kim, Moonhwan, Lee, Jun Suh, Lee, Boram, Jo, Yeongsoo, Kim, Haeryoung, Na, Hee Young, Lee, Yangkyu, Ahn, Soomin, Choe, Ji-Young, Han, Ho-seong, Yoon, Yoo-Seok
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Pancreatic Ductal - mortality
Carcinoma, Pancreatic Ductal - pathology
Carcinoma, Pancreatic Ductal - surgery
Disease-Free Survival
Female
Humans
Male
Margin status
Margins of Excision
Mesenteric Veins - pathology
Mesenteric Veins - surgery
Middle Aged
Neoplasm Recurrence, Local
Pancreatic ductal adenocarcinoma
Pancreatic head cancer
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy
Pancreatoduodenectomy
Prognosis
Prospective Studies
Resection margin
Survival Analysis
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Summary:The prognostic significance of circumferential resection margin (CRM) or circumferential surface (CS) in pancreatic head cancer is controversial. We investigated the survival outcomes according to CRM or CS involvement in pancreatoduodenectomy specimens of pancreatic ductal adenocarcinoma (PDAC). A total of 102 pancreatoduodenectomy specimens after upfront surgery for PDAC between 2014 and 2018 were prospectively collected. The superior mesenteric vein/portal vein or superior mesenteric artery margins were classified as CRM, and the anterior or posterior surfaces as CS. Survival outcomes and recurrence were compared according to the CRM/CS status, which was categorized into R10mm, R11mm, and R0 (≥1 mm) by the 0 and 1 mm rules. For CRM, R10mm had significantly lower overall survival (OS) (P 
ISSN:1424-3903
1424-3911
1424-3911
DOI:10.1016/j.pan.2024.09.003