R1 resection in pancreatic cancer has significant impact on long-term outcome in standardized pathology modified for routine use

Rau, Bettina; Moritz, Katharina; Schuschan, Sarah; Alsfasser, Guido; Prall, Friedrich; Klar, E.

doi:10.1016/j.surg.2012.05.015

Cited by 130 publications

(106 citation statements)

References 28 publications

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“…Furthermore, 2 patients in the present study had multiple MUP(+) sites (22.2%), mainly in Area B, at a rate lower than that described in other reports 9,20 . This result was due to the exclusion of patients with borderline resectable pancreatic cancer 15 and patients with PLsma invasive pancreatic cancer and the execution of en bloc dissection via the left posterior approach for PD 36,38 .…”

Section: Discussioncontrasting

confidence: 72%

Usefulness of Color Coding Resected Samples from a Pancreaticoduodenectomy with Tissue Marking Dyes for a Detailed Examination of Surgical Margin Surrounding the Uncinate Process of the Pancreas

et al. 2017

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Background: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy.The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexuspreserving pancreaticoduodenectomy. Results of this evaluation were used to review operation procedures and perioperative methods. Method:We divided the MUP into 4 sections and stained each section with a different color. These sections were the pancreatic head nerve plexus margin (Area A), portal vein groove margin (Area B), superior mesenteric artery margin (Area C), and left of the superior mesenteric artery margin (Area D). The subjects evaluated were 45 patients who had carcinoma of the pancreatic head and were treated with circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy. Results

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Section: Discussioncontrasting

confidence: 72%

Usefulness of Color Coding Resected Samples from a Pancreaticoduodenectomy with Tissue Marking Dyes for a Detailed Examination of Surgical Margin Surrounding the Uncinate Process of the Pancreas

et al. 2017

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“…After implementation of the Glasgow group's histopathologic protocol in several other centers of pancreatic surgery, data were presented with rather inconclusive results. Some of these studies analyzed inhomogeneous patient groups including bile duct and ampullary carcinomas [8,23,24]. Posterior aspect 11 19 More than one localization 10 18 Intrapancreatic transection surface 5 9…”

Section: Discussionmentioning

confidence: 99%

Resection Margin Clearance in Pancreatic Cancer After Implementation of the Leeds Pathology Protocol (LEEPP): Clinically Relevant or Just Academic?

et al. 2014

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“…In patients with primary resectable tumours, we recommend proceeding with surgery, followed by adjuvant therapy and enrolment on adjuvant treatment studies such as pa. 6 or accord 24 (phase iii trials comparing 6 months of adjuvant gemcitabine or folfirinox in completely resected pcc) or Radiation Therapy Oncology Group 0848 (phase iii trial evaluating the combination of erlotinib and chemoradiation in completely resected adenocarcinoma of the pancreatic head).…”

Section: Discussion and Summarymentioning

confidence: 99%

“…Only complete surgical resection (CR0) can be considered a curative modality, but most resections are reported to have microscopically positive margins (CR1), with a 74%-80% risk of recurrence 5,6 . Overall, 5-year post-resection survival is 7%-24%, with a median survival of about 1 year 7 given the small, but statistically significant, role of adjuvant chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Role of Neoadjuvant Therapy in the Management of Pancreatic Cancer: Is the Era of Biomarker-Directed Therapy Here?

Цветкова

Asmis

2014

Current Oncology

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Pancreatic cancer is the 4th leading cause of cancerrelated death. Complete surgical resection (CR0) is considered the only curative treatment. Most patients present with unresectable or borderline resectable disease. Many small phase i/ii trials have tried to address the role of neoadjuvant treatment using chemotherapy with or without chemoradiation in the management of locally advanced disease. However, many of them looked at the rate of CR0 resection and the feasibility of such treatment. A trend for improved overall survival has been observed in the group of patients with borderline resectable disease who completed neoadjuvant treatment. A large proportion of patients progress while on treatment, sparing them from unnecessary surgery. We searched the PubMed database (using the key words “pancreatic cancer,” or “pancreatic neoplasm,” or “pancreatic adenocarcinoma,” and “neoadjuvant treatment,” or “neoadjuvant chemotherapy,” or “neoadjuvant radiation therapy,” or “neoadjuvant chemoradiation,” or “adjuvant therapy” [all fields] and “clinical trial” or “study”) and abstracts presented at the American Society of Clinical Oncology meetings on gastrointestinal cancers. Here, we review the most recent papers that present results on neoadjuvant therapy in pancreatic cancer. All but one report used overall survival as an endpoint. Unfortunately, there are no valid biomarkers predicting tumour progression or recurrence, and response to treatment than can help to guide therapeutic choices. Our recommendation is to consider neoadjuvant treatment in cases of borderline resectable disease. In patients with primary resectable tumours, surgery followed by adjuvant treatment and enrollment on adjuvant treatment studies would be appropriate.

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R1 resection in pancreatic cancer has significant impact on long-term outcome in standardized pathology modified for routine use

Cited by 130 publications

References 28 publications

Usefulness of Color Coding Resected Samples from a Pancreaticoduodenectomy with Tissue Marking Dyes for a Detailed Examination of Surgical Margin Surrounding the Uncinate Process of the Pancreas

Usefulness of Color Coding Resected Samples from a Pancreaticoduodenectomy with Tissue Marking Dyes for a Detailed Examination of Surgical Margin Surrounding the Uncinate Process of the Pancreas

Resection Margin Clearance in Pancreatic Cancer After Implementation of the Leeds Pathology Protocol (LEEPP): Clinically Relevant or Just Academic?

Role of Neoadjuvant Therapy in the Management of Pancreatic Cancer: Is the Era of Biomarker-Directed Therapy Here?

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