TY  - JOUR
A1  - Loch, Florian N.
A1  - Kamphues, Carsten
A1  - Rieger, Freschta
A1  - Beyer, Katharina
A1  - Rayya, Wael
A1  - Schineis, Christian
A1  - Klauschen, Frederick
A1  - Horst, David
A1  - Schallenberg, Simon
A1  - Dragomir, Mihnea P.
T1  - Stepwise analysis of resection margin impact on survival and distant metastasis in pancreatic head ductal adenocarcinoma
T2  - International Journal of Surgical Pathology
N2  - The prognostic role of tumor cells in pancreatic ductal adenocarcinoma (PDAC) of the pancreatic head with direct microscopic infiltration (DMI) or in close proximity (≤1 mm) to the resection margin (RM) remains unclear. This single-center, retrospective study included specimens from 75 patients who underwent oncological resection of pancreatic head PDAC between February 2013 and July 2020. Two pathologists independently re-measured the distance between tumors and the multiple RMs. The impact of RM involvement for DMI, tumor cells within ≤1 mm, in general, and for individual RMs on overall survival (OS) and development of distant pulmonary (PM) and hepatic (HM) metastasis was analyzed. DMI of RMs was significantly associated with a shorter OS (median 5 vs 19 months, P = .02). The presence of tumor cells within ≤1 mm of RMs yielded a negative impact on OS with a trend toward significance (median 9 vs 21 months, P = .09). DMI and tumor cells within ≤1 mm of the pancreatic transection margin (PRM), individually, had a significant negative impact on OS (median 4 vs 19 months and 6 vs 19 months, P < .05), but not for any other individual RM. RM involvement of ≤1 mm of only the vascular circumferential resection margin (VCRM) resulted in a shorter time to HM development (P = 0.05). DMI of the posterior circumferential resection margin (PCRM) and VCRM, individually, showed shorter time to PM (P < .05). Potential clinical considerations include extended intraoperative evaluation of the PRM (1 mm) and intensified preoperative prediction of R1 resection as a basis for neoadjuvant therapy.
Y1  - 2024
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/123719
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1237195
SN  - 1066-8969
SN  - 1940-2465
VL  - 32
IS  - 8
SP  - 1429
EP  - 1440
PB  - SAGE Publications
ER  -