ArticleAnnals of surgical oncology2023
Nationwide Impact of Centralization, Neoadjuvant Therapy, Minimally Invasive Surgery, and Standardized Pathology Reporting on R0 Resection and Overall Survival in Pancreatoduodenectomy for Pancreatic Cancer.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Radicality and safety of total mesopancreatic excision in pancreatoduodenectomy: a systematic review and meta-analysis.World journal of surgical oncology · 2024Pooled it
- Standardizing computed tomographic assessment of the mesopancreas in pancreatic cancer patients.Abdominal radiology (New York) · 2026Article
- Low prealbumin predicts early recurrence after pancreatic cancer surgery: a retrospective cohort study.Gland surgery · 2026Article
- Article
- Pancreatic cancer.Nature reviews. Disease primers · 2026Review
- Increased incidence, survival, and registration quality of primary hepato-pancreato-biliary cancers in the Netherlands Cancer Registry.International journal of cancer · 2026Article
- Conversion and resection rates in borderline resectable and locally advanced pancreatic cancer following neoadjuvant therapy: a retrospective multicenter cohort study.Frontiers in oncology · 2026Article
- Prognostic factors analysis of surgical resection after conversion therapy for isolated pleural metastatic lung cancer: a retrospective analysis.Frontiers in medicine · 2026Article
- Patient preferences for pancreatic cancer treatment (PERSEUS): a multicenter discrete choice experiment.Health and quality of life outcomes · 2025Article
- Oncological outcome after robot-assisted versus open pancreatoduodenectomy for upfront resectable cancer in the pancreatic head: a nationwide cohort analysis.The British journal of surgery · 2025Observational
- Comparison of Total Mesopancreatic Excision and Conventional Pancreaticoduodenectomy in the Surgical Treatment of Pancreatic Head Adenocarcinoma: Early Postoperative Outcomes.Medicina (Kaunas, Lithuania) · 2025Article
- Trends in the Treatment and Survival of Pancreatic Cancer: Analysis of 23,339 Patients Diagnosed Between 2010 and 2017.Cancer medicine · 2025Article
- Modern Treatment Strategies for Borderline Resectable Pancreatic Cancer.Cancer treatment and research · 2024Review
Corrections and comments
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Authors and funding
19 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundSurgeons aim for R0 resection in patients with pancreatic cancer to improve overall survival. However, it is unclear whether recent changes in pancreatic cancer care such as centralization, increased use of neoadjuvant therapy, minimally invasive surgery, and standardized pathology reporting have influenced R0 resections and whether R0 resection remains associated with overall survival.
methodsThis nationwide retrospective cohort study included consecutive patients after pancreatoduodenectomy (PD) for pancreatic cancer from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Database (2009-2019). R0 resection was defined as > 1 mm tumor clearance at the pancreatic, posterior, and vascular resection margins. Completeness of pathology reporting was scored on the basis of six elements: histological diagnosis, tumor origin, radicality, tumor size, extent of invasion, and lymph node examination.
resultsAmong 2955 patients after PD for pancreatic cancer, the R0 resection rate was 49%. The R0 resection rate decreased from 68 to 43% (2009-2019, P < 0.001). The extent of resections in high-volume hospitals, minimally invasive surgery, neoadjuvant therapy, and complete pathology reports all significantly increased over time. Only complete pathology reporting was independently associated with lower R0 rates (OR 0.76, 95% CI 0.69-0.83, P < 0.001). Higher hospital volume, neoadjuvant therapy, and minimally invasive surgery were not associated with R0. R0 resection remained independently associated with improved overall survival (HR 0.72, 95% CI 0.66-0.79, P < 0.001), as well as in the 214 patients after neoadjuvant treatment (HR 0.61, 95% CI 0.42-0.87, P = 0.007).
conclusionsThe nationwide rate of R0 resections after PD for pancreatic cancer decreased over time, mostly related to more complete pathology reporting. R0 resection remained associated with overall survival.
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