Tumor‐positive resection margins reflect an aggressive tumor biology in pancreatic cancer

Abstract

Factors associated with an R1 resection reflect a biologically more aggressive tumor, with a higher likelihood of microvascular invasion and increased positive lymph node ratio.

Variant hepatic arterial anatomy encountered during pancreatoduodenectomy does not influence postoperative outcomes or resection margin status: A matched pair analysis of 105 patients

“…The R1 resection was a predictor of worse survival in various studies . PDAC patients with R0 resection had longer survival than those with R1 or R0 with tumor within a 1‐mm surgical margin .…”

“…The R1 resection was a predictor of worse survival in various studies . PDAC patients with R0 resection had longer survival than those with R1 or R0 with tumor within a 1‐mm surgical margin . Survival also depends on the topography of the positive resection margin (patients with anterior/posterior (+) margins have longer survival than of patients with medial (+) margins) .…”

Mesopancreatic Stromal Clearance Defines Curative Resection of Pancreatic Head Cancer and Can Be Predicted Preoperatively by Radiologic Parameters

“…Similar observations have been reported by other authors for the correlation of R-status with lymphangiosis and lymph node metastasis. 39,40 Further biologic interpretation remains to be examined. On the basis of our data we cannot decide whether peritumoral fibrotic stroma left in place results in cancer recurrence or whether stromal clearance is just a sensitive surrogate marker of undetected dispersed cancer cells left behind.…”

Frozen section of the pancreatic neck margin in pancreatoduodenectomy for pancreatic adenocarcinoma is of limited utility

“…15 The question of whether a complete R0 resection improves prognosis has been controversial and much may depend on both the pathological sampling employed and the definition of an involved margin. 6,7,9,[16][17][18] Chang et al found that a positive resection margin remained prognostically significant even when the definition of R1 extended to a margin 1.5 mm. 4 Were we to apply this definition to our data, we would find the number of R0(s) resections would reduce to five, the median overall survival of groups would be unchanged and no statistically significant difference would be found in survival between the three resection margin groups (data not shown).…”