ArticleAnnals of surgical oncology2022
Prognostic Impact of Resection Margin Status in Distal Pancreatectomy for Ductal Adenocarcinoma.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 18 citations in OpenAlex.
- Tumor-to-anterior pancreas surface distance on CT: a potential preoperative predictor of resection margin status in pancreatic body and tail adenocarcinoma.European radiology · 2026Article
- Article
- From metabolic syndrome to survival: a prognostic model for PDAC incorporating insulin resistance markers and pathological variables.Frontiers in endocrinology · 2026Article
- An injury-associated lobular microniche is associated with the classical tumor cell phenotype in pancreatic cancer.Nature communications · 2025Article
- Institutional learning curve and factors of prolonged operation time of robotic distal pancreatectomy: An analysis of an initial 117 cases.Annals of gastroenterological surgery · 2025Article
- Minimally invasive versus open distal pancreatectomy for resectable pancreatic cancer (DIPLOMA): an international randomised non-inferiority trial.The Lancet regional health. Europe · 2023Article
- Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma.Current oncology (Toronto, Ont.) · 2022Review
- ASO Author Reflections: Resection Margins in Distal Pancreatectomy for Ductal Adenocarcinoma-Does Surgery Tell the Whole Story?Annals of surgical oncology · 2022Article
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10 authors at 2 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundResection margin status is considered one of the few surgeon-controlled parameters affecting prognosis in pancreatic ductal adenocarcinoma (PDAC). While studies mostly focus on resection margins in pancreatoduodenectomy, little is known about their role in distal pancreatectomy (DP). This study aimed to investigate resection margins in DP for PDAC.
methodsPatients who underwent DP for PDAC between October 2004 and February 2020 were included (n = 124). Resection margins and associated parameters were studied in two consecutive time periods during which different pathology examination protocols were used: non-standardized (period 1: 2004-2014) and standardized (period 2: 2015-2020). Microscopic margin involvement (R1) was defined as ≤1 mm clearance.
resultsLaparoscopic and open resections were performed in 117 (94.4%) and 7 (5.6%) patients, respectively. The R1 rate for the entire cohort was 73.4%, increasing from 60.4% in period 1 to 83.1% in period 2 (p = 0.005). A significantly higher R1 rate was observed for the posterior margin (35.8 vs. 70.4%, p < 0.001) and anterior pancreatic surface (based on a 0 mm clearance; 18.9 vs. 35.4%, p = 0.045). Pathology examination period, poorly differentiated PDAC, and vascular invasion were associated with R1 in the multivariable model. Extended DP, positive anterior pancreatic surface, lymph node ratio, perineural invasion, and adjuvant chemotherapy, but not R1, were significant prognostic factors for overall survival in the entire cohort.
conclusionsPathology examination is a key determinant of resection margin status following DP for PDAC. A high R1 rate is to be expected when pathology examination is meticulous and standardized. Involvement of the anterior pancreatic surface affects prognosis.
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