ArticleMedicine2016
Mesopancreatic Stromal Clearance Defines Curative Resection of Pancreatic Head Cancer and Can Be Predicted Preoperatively by Radiologic Parameters: A Retrospective Study.
Article in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Systematic review of the mesopancreas: concept and clinical implications.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018Pooled it
- Consensus in determining the resectability of locally progressed pancreatic ductal adenocarcinoma - results of the Conko-007 multicenter trial.BMC cancer · 2019Trial
- Standardizing computed tomographic assessment of the mesopancreas in pancreatic cancer patients.Abdominal radiology (New York) · 2026Article
- Article
- The Role of the Mesopancreas in Pancreatic Neuroendocrine Neoplasms.Journal of clinical medicine · 2026Article
- Comparison of Total Mesopancreatic Excision and Conventional Pancreaticoduodenectomy in the Surgical Treatment of Pancreatic Head Adenocarcinoma: Early Postoperative Outcomes.Medicina (Kaunas, Lithuania) · 2025Article
- Most oncological pancreas resections must consider the mesopancreas.BMC cancer · 2025Article
- Impact of overweight on patients undergoing laparoscopic pancreaticoduodenectomy: analysis of surgical outcomes in a high-volume center.BMC surgery · 2024Article
- Article
- Pre-Operative MDCT Staging Predicts Mesopancreatic Fat Infiltration-A Novel Marker for Neoadjuvant Treatment?Cancers · 2021Article
- Timing But Not Patterns of Recurrence Is Different Between Node-negative and Node-positive Resected Pancreatic Cancer.Annals of surgery · 2020Article
- Total mesopancreas excision for periampullary malignancy: a single-center propensity score-matched comparison of long-term outcomes.Langenbeck's archives of surgery · 2020Article
- Article
- Article
- Mesenteric approach during pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.Annals of gastroenterological surgery · 2017Article
- The Role of Fibroblasts in Pancreatic Cancer: Extracellular Matrix Versus Paracrine Factors.Translational oncology · 2017Article
- Pregnancy Specific β-1 Glycoprotein 1 is Expressed in Pancreatic Ductal Adenocarcinoma and its Subcellular Localization Correlates with Overall Survival.Journal of Cancer · 2016Article
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Authors and funding
20 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is characterized by a strong fibrotic stromal reaction and diffuse growth pattern. Peritumoral fibrosis is often evident during surgery but only distinguishable from tumor by microscopic examination. The aim of this study was to investigate the role of clearance of fibrotic stromal reaction at the mesopancreatic resection margin as a criterion for radical resection and preoperative assessment of resectability.Mesopancreatic stromal clearance status (S-status) was defined as the presence or absence (S+/S0) of fibrotic stromal reaction at the mesopancreatic resection margin. Detailed retrospective clinicopathologic re-evaluation of margin status and preoperative cross-sectional imaging was performed in a cohort of 91 patients operated for pancreatic head PDAC from 2001 to 2011.Conventional margin positive resection (R+, tumor cells directly at the margin) was found in 36%. However, S-status further divided the margin negative (R0) group into patients with median survival of 14 months versus 31 months (S+ versus S0, P = 0.005). Overall rate of S+ was 53%. S-status and lymph node ratio constituted the only independent predictors of survival. Stranding of the superior mesenteric artery fat sheath was the only independent radiologic predictor of S+ resection, and achieved a 71% correct prediction of S-status.Mesopancreatic stromal clearance is a major determinant of curative resection in PDAC, and preoperative prediction by cross-sectional imaging is possible, setting the basis for a new definition of borderline resectability.
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