ArticleAnnals of surgical oncology2018
Pathological Margin Clearance and Survival After Pancreaticoduodenectomy in a US and European Pancreatic Center.
Article in Annals of surgical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Prognostic relevance of the revised R status definition in pancreatic cancer: meta-analysis.BJS open · 2022Pooled it
- Pathology of Treated Pancreatic Ductal Adenocarcinoma and Its Clinical Implications.Archives of pathology & laboratory medicine · 2020Pooled it
- Implications of an Isolated Positive Vascular Groove After Whipple for Pancreatic Adenocarcinoma: A Single Institution, Retrospective Analysis.Journal of surgical oncology · 2025Article
- Article
- Vein Wall Invasion Is a More Reliable Predictor of Oncological Outcomes than Vein-Related Margins after Pancreaticoduodenectomy for Early Stages of Pancreatic Ductal Adenocarcinoma.Diagnostics (Basel, Switzerland) · 2023Article
- Article
- Article
- Impact of molecular surgical margin analysis on the prediction of pancreatic cancer recurrences after pancreaticoduodenectomy.Clinical epigenetics · 2021Article
- Prospective Evaluation of Resection Margins Using Standardized Specimen Protocol Analysis among Patients with Distal Cholangiocarcinoma and Pancreatic Ductal Adenocarcinoma.Journal of clinical medicine · 2021Article
- Borderline resectable pancreatic cancer and vascular resections in the era of neoadjuvant therapy.World journal of clinical cases · 2021Review
- Detailed Analysis of Margin Positivity and the Site of Local Recurrence After Pancreaticoduodenectomy.Annals of surgical oncology · 2021Article
- Clinical impacts of resection margin status and clinicopathologic parameters on pancreatic ductal adenocarcinoma.World journal of surgical oncology · 2020Article
- Hypovascular pancreas head adenocarcinoma: CT texture analysis for assessment of resection margin status and high-risk features.European radiology · 2020Article
- Three-Dimensional Fixation: Pathological Protocol Following Pancreaticoduodenectomy with Portal Vein Resection for Pancreatic Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe optimal definition of a margin-negative resection and its exact prognostic significance on survival in resected pancreatic adenocarcinoma remains unknown. This study was designed to assess the relationship between pathological margin clearance, margin type, and survival.
methodsPatients who underwent pancreaticoduodenectomy with curative intent at two academic institutions, in Amsterdam, the Netherlands, and Boston, Massachusetts, between 2000 and 2014 were retrospectively evaluated. Overall survival, recurrence rates, and progression-free survival (PFS) were assessed by Kaplan-Meier estimates and multivariate Cox proportional hazards analysis, according to pathological margin clearance and type of margin involved.
resultsOf 531 patients identified, the median PFS was 12.9, 15.4, and 24.1 months, and the median overall survival was 17.4, 22.9, and 27.7 months for margin clearances of 0, < 1, and ≥1 mm, respectively (all log-rank p < 0.001). On multivariate analysis, patients with a margin clearance of ≥1 mm demonstrated a survival advantage relative to those with 0 mm clearance [hazard ratio (HR) 0.71, p < 0.01], whereas survival was comparable for patients with a margin clearance of < 1 mm versus 0 mm (HR: 0.93, p = 0.60). Patients with involvement (0 or < 1 mm margin clearance) of the SMV/PV margin demonstrated prolonged median overall survival (25.7 months) relative to those with SMA involvement (17.5 months).
conclusionsIn patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma, a margin clearance of ≥1 mm correlates with improved survival relative to < 1 mm clearance and may be a more accurate predictor of a complete margin-negative resection in pancreatic cancer. The type of margin involved also appears to impact survival.
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