SynthesisScientific reports2020
Impact of intraoperative margin clearance on survival following pancreatoduodenectomy for pancreatic cancer: a systematic review and meta-analysis.
Synthesis in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- The Practices of Pancreatic Neck Margin Testing and Their Outcomes after Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma.Annals of surgical oncology · 2026Article
- Informing Decision-making for Transected Margin Reresection in Intraductal Papillary Mucinous Neoplasm-derived Pancreatic Cancer: An International Multicenter Study.Annals of surgery · 2026Article
- Analysis of Short-Term Outcomes in Pancreatic Surgery with Vascular Resection from a Prospective Multicenter Global Study.Annals of surgical oncology · 2025Observational
- Intraoperative liquid biopsy as a tool for detecting R1 resection during pancreatoduodenectomy in patients with pancreatic carcinoma: the CETUPANC trial (part II).International journal of surgery (London, England) · 2024Article
- Stepwise Analysis of Resection Margin Impact on Survival and Distant Metastasis in Pancreatic Head Ductal Adenocarcinoma.International journal of surgical pathology · 2024Article
- Serum and tissue metallome of pancreatic ductal adenocarcinoma.Cancer science · 2024Article
- Utility and diagnostic accuracy of intraoperative frozen sections in hepato-pancreato-biliary surgical pathology.Langenbeck's archives of surgery · 2023Article
- Utility of intraoperative pathology consultations of whipple resection specimens and their impact on final margin status.Heliyon · 2023Article
- Is Margin Status Less Prognostic After Neoadjuvant Chemoradiotherapy for Pancreatic Adenocarcinoma?Annals of surgical oncology · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The use of intraoperative margin revision to achieve margin clearance in patients undergoing pancreatoduodenectomy for pancreatic cancer is controversial. We performed a systematic review and meta-analysis to summarize the evidence of intraoperative margin revisions of the pancreatic neck and its impact on overall survival (OS). Nine studies with 4501 patients were included. Patient cohort was stratified in an R0R0-group (negative margin on frozen and permanent section), R1R0-group (revised positive margin on frozen section which turned negative on permanent section), and R1R1-group (positive margin on frozen and permanent section despite margin revision). OS was higher in the R1R0-group (HR 0.83, 95% CI 0.72-0.96, P = 0.01) compared to the R1R1-group but lower compared to the R0R0-group (HR 1.20; 95% CI 1.05-1.37, P = 0.008), respectively. Subgroup analyses on the use of different margin clearance definitions confirmed an OS benefit in the R1R0-group compared to the R1R1-group (HR 0.81; 95% CI 0.65-0.99, P = 0.04). In conclusion, intraoperative margin clearance of the pancreatic neck margin is associated with improved OS while residual tumor indicates aggressive tumor biology. Consensus definitions on margin terminologies, clearance, and surgical techniques are required.
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