Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma
Pancreatic cancer is associated with a poor prognosis. While surgical resection is the only treatment option with curative intent, most patients die of locoregional and/or distant recurrence. The prognostic impact of the resection margin status has received much attention. However, the evidence is a...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-09-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/29/9/515 |
| _version_ | 1827662016754483200 |
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| author | Maia Blomhoff Holm Caroline Sophie Verbeke |
| author_facet | Maia Blomhoff Holm Caroline Sophie Verbeke |
| author_sort | Maia Blomhoff Holm |
| collection | DOAJ |
| description | Pancreatic cancer is associated with a poor prognosis. While surgical resection is the only treatment option with curative intent, most patients die of locoregional and/or distant recurrence. The prognostic impact of the resection margin status has received much attention. However, the evidence is almost exclusively related to pancreatoduodenectomies, while corresponding data for distal pancreatectomy specimens are limited. The key data, such as the rate of microscopic margin involvement (“R1”), the site of margin involvement, and the impact of R1 on patient outcome, are divergent between studies and do not currently allow any general conclusions. The main reasons for the variability in the published data are the small size of the study cohorts and their heterogeneity, as well as the marked divergence in pathology examination practices. The latter is a consequence of the lack of concrete guidance, both for grossing and microscopic examination. The increasing administration of neoadjuvant chemo(radio)therapy introduces a further factor of uncertainty as the conventional definition of a tumour-free margin (“R0”) based on 1 mm clearance is inadequate for these specimens. This review discusses the published data regarding the prognostic impact of margin status in distal pancreatectomy specimens along with the challenges and uncertainties that are related to the assessment of the margins. |
| first_indexed | 2024-03-10T00:19:15Z |
| format | Article |
| id | doaj.art-c509ce11c9714bd0beac84ebd94f08d5 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T00:19:15Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-c509ce11c9714bd0beac84ebd94f08d52023-11-23T15:46:07ZengMDPI AGCurrent Oncology1198-00521718-77292022-09-012996551656310.3390/curroncol29090515Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal AdenocarcinomaMaia Blomhoff Holm0Caroline Sophie Verbeke1Department of Pathology, Faculty of Medicine, University of Oslo, 0372 Oslo, NorwayDepartment of Pathology, Faculty of Medicine, University of Oslo, 0372 Oslo, NorwayPancreatic cancer is associated with a poor prognosis. While surgical resection is the only treatment option with curative intent, most patients die of locoregional and/or distant recurrence. The prognostic impact of the resection margin status has received much attention. However, the evidence is almost exclusively related to pancreatoduodenectomies, while corresponding data for distal pancreatectomy specimens are limited. The key data, such as the rate of microscopic margin involvement (“R1”), the site of margin involvement, and the impact of R1 on patient outcome, are divergent between studies and do not currently allow any general conclusions. The main reasons for the variability in the published data are the small size of the study cohorts and their heterogeneity, as well as the marked divergence in pathology examination practices. The latter is a consequence of the lack of concrete guidance, both for grossing and microscopic examination. The increasing administration of neoadjuvant chemo(radio)therapy introduces a further factor of uncertainty as the conventional definition of a tumour-free margin (“R0”) based on 1 mm clearance is inadequate for these specimens. This review discusses the published data regarding the prognostic impact of margin status in distal pancreatectomy specimens along with the challenges and uncertainties that are related to the assessment of the margins.https://www.mdpi.com/1718-7729/29/9/515pancreatic cancermarginpathologyprognosis |
| spellingShingle | Maia Blomhoff Holm Caroline Sophie Verbeke Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma Current Oncology pancreatic cancer margin pathology prognosis |
| title | Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma |
| title_full | Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma |
| title_fullStr | Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma |
| title_full_unstemmed | Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma |
| title_short | Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma |
| title_sort | prognostic impact of resection margin status on distal pancreatectomy for ductal adenocarcinoma |
| topic | pancreatic cancer margin pathology prognosis |
| url | https://www.mdpi.com/1718-7729/29/9/515 |
| work_keys_str_mv | AT maiablomhoffholm prognosticimpactofresectionmarginstatusondistalpancreatectomyforductaladenocarcinoma AT carolinesophieverbeke prognosticimpactofresectionmarginstatusondistalpancreatectomyforductaladenocarcinoma |