Can the new RCP R0/R1 classification predict the clinical outcome in ductal adenocarcinoma of the pancreatic head?

Abstract

Our study has shown that the RCP suggestion for R status has no impact on the prognosis of PDAC. In contrast, our data confirmed the UICC R classification of RM as well as N category, grading, and lymph node ratio as significant prognostic factors.

Impact of lymph node ratio on survival in patients with pancreatic and periampullary cancer

“…LNR could thus be a more objective parameter than resection margin. This supports the findings of a recent study (although a small number of patients were analysed) that showed no impact on survival in patients with PDAC when the current R1 definition was used, although LNR remained a strong prognostic factor.…”

Impact of Resection Margin Distance on Survival of Pancreatic Cancer: A Systematic Review and Meta-Analysis

“…In this meta-analysis, six studies explained details of standardized pathological examination. Eventually, when ‘1 mm rule’ was applied, R1 rates were greater than 35.6% except a study by Janot et al [24] which had low number of patients.…”

“…While most common involved margin in the pancreatic cancer is the medial or posterior resection margin [15], Jamieson et al [35] reported that R1 at anterior surface made up 12.8% of the R1 cases and that these patients presented favorable outcome than those with R1 at medial or transection margin. In this meta-analysis, anterior surface was considered a resection margin in only two studies [17,24]. …”

Pathologie der R1-Klassifikation in der viszeralonkologischen Chirurgie

“…Auffallenderweise unterscheiden sich internationale Studien signifikant in ihren R1-Raten mit großen Schwankungsbreiten von 20-80 % bei nur gering variierenden patienten-und tumorbezogenen Merkmalen [5,8,15,33,40]. Diese Unterschiede sind auf einen fehlenden Konsens hinsichtlich der Definition des R-Status beim Pankreaskarzinom zurückzuführen.…”