Microscopically positive (R1) resections do not affect survival in pancreatic head cancer

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COD: 04-2694 Categorie: ,

Emil Mois, Florin Graur, Nadim Al-Hajjar, Florin Zaharie, Adrian Bartos, Raluca Bodea, T. Zaharie, I. Rusu, Cornel Iancu

Ann. Ital. Chir., 2017 88, 6: 491-496

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BACKGROUND: Obtaining negative microscopic resection margins (R0) in cephalic duodenopancreatectomy (CDP) is the
gold standard. Resection line involvement at microscopic histopathological examination (R1) could change prognostic unfavorable.
Regarding R1 resections in CDP (data from the literature show rates between 20-80%), we considered it necessary
to perform a study in Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor’’ Cluj-Napoca.
METHODS: Here we present the results of a retrospective study carried out between January 2012 – December 2013 in
our Institute. This study includes 63 patients with pancreatic head resections for pancreatic cancer. The circumferential
soft tissue margin, the pancreatic transection margin, the bile duct and duodenum/stomach margins were analyzed. We
investigated the incidence of R1 and its impact on the survival rates after oncologic pancreatic resections using a nonstandardized
pathologic routine protocol. R1 status was defined as the distance of the tumor from the resection margin
of ≤ 1 mm.
RESULTS: Pancreatic ductal adenocarcinoma (PDAC) was diagnosed in 93.65 %. The R1 rate was 36.5 % (23 cases).
The circumferential margins were most commonly involved as R1 (91,3%). No statistically significant differences were
found between patients with R1 to those with R0 (p ≥ 0.1) regarding 3-year survival.
CONCLUSIONS: Survival for pancreatic head cancer at 3 years is not influenced by the margins of resection (R1/R0).
Microscopic resection margin involvement is not an independent marker of survival.

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