Impact of Resection Status on Pattern of Failure and Survival After Pancreaticoduodenectomy for Pancreatic Adenocarcinoma

Raut, Chandrajit P.; Tseng, Jennifer F.; Sun, Charlotte C.; Wang, Huamin; Wolff, Robert A.; Crane, Christopher H.; Hwang, Rosa F.; Vauthey, Jean Nicolas; Abdalla, Eddie K.; Lee, Jeffrey E.; Pisters, Peter W.T.; Evans, Douglas B.

doi:10.1097/01.sla.0000259391.84304.2b

Cited by 529 publications

(440 citation statements)

References 52 publications

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“…Insufficient examination of the Although most investigators report overall resection margin involvement to be an independent prognostic factor, some have concluded otherwise. [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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Laparoscopic pancreaticoduodenectomy (LPD) remained a formidable challenge owing to retroperitoneal location, difficult dissection near great vessels and critical intracorporeal anastomoses. Recent reviews of literature have established the feasibility and comparable short term outcomes of laparoscopic pancreaticoduodenectomy (LPD) with that of open pancreaticoduodenectomy (OPD). This study was undertaken to compare the pathological radicality of LPD with OPD. A prospective database of all patients who underwent standard pancreaticoduodenectomy from Mar 2006 to Feb 2011 was taken up for this study. 45 patients who underwent LPD and 118 patients who underwent OPD for periampullary and pancreatic head malignancy were taken up for analysis. The study groups were comparable in terms of age of presentation, ASA grades, comorbidity, type of surgery and BMI. There was no statistically significant difference with regard to tumor size, lymph node yield, node positivity rates, R1 rates and margin lengths. The pathological radicality of laparoscopic pancreaticoduodenectomy is comparable with that of open approach when performed by experienced minimal-access surgeons. Standardized protocols for evaluation of the resection margins should be mandatory in studies reporting outcomes of pancreaticoduodectomy.

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Section: Discussionmentioning

confidence: 99%

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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“…Patients with American Joint Committee on Cancer (AJCC) stages I and II pancreatic adenocarcinoma and who are treated with multimodality therapy, including surgery, have a median survival period that may exceed 2 years as well as a potential for cure (34). However, surgery is not an option for patients who initially present with locally advanced (AJCC stage III) disease and who have a reported median survival period of less than 12 months (35).…”

Section: Discussionmentioning

confidence: 99%

Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT

Park

Lee

Choi

et al. 2009

Magnetic Resonance Imaging

139

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Purpose:To determine the accuracy of magnetic resonance imaging (MRI) including dynamic imaging using three-dimensional gradient-echo (3D-GRE) sequences and MR cholangiopancreatograpy (MRCP) compared with that of multidetector row CT (MDCT) with regard to resectability in pancreas cancer. Materials and Methods:From February 2004 to July 2008, 54 patients (32 men, 22 women: age range, 28 -83 years; mean age, 63.1 years old) with surgically proven pancreatic carcinoma, who had undergone preoperative gadolinium-enhanced 3D-GRE MRI with MRCP and triplephase MDCT, were included in this retrospective study. Two, clinically experienced attending radiologists independently reviewed the two image sets. These readers evaluated the tumor conspicuity, presence of vascular invasion, choledochal and duodenal invasion, lymph node metastases, distant metastasis, and tumor resectability. The results were compared with the surgical and histopathologic findings using receiver operating characteristic analysis (Az) and kappa statistics. Results:Curative resections were performed on 42 patients. Regarding the tumor conspicuity, MRI had a significantly higher Az value compared with MDCT according to both reviewers (P Ͻ 0.05). The accuracy of resectability was Az ϭ 0.753 and 0.768 on MRI and Az ϭ 0.829 and 0.762 on MDCT for each reviewer, and the difference in the accuracy of resectability was not significant between MRI and MDCT for either reviewer (P Ͼ 0.05). Two imaging sets showed a similar diagnostic performance in the evaluation of vascular involvement, lymph node metastasis, and distant metastasis.Conclusion: Dynamic 3D-GRE MRI with MRCP shows superior tumor conspicuity and similar diagnostic performance compared with MDCT in evaluating the resectability of pancreatic cancer.

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“…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.…”

Section: Pankreaskarzinomunclassified

Pathologie der R1-Klassifikation in der viszeralonkologischen Chirurgie

Pollheimer

Langner

2017

Chirurg

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Impact of Resection Status on Pattern of Failure and Survival After Pancreaticoduodenectomy for Pancreatic Adenocarcinoma

Cited by 529 publications

References 52 publications

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT

Pathologie der R1-Klassifikation in der viszeralonkologischen Chirurgie

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