OBJECTIVE: To assess the effect of R0 resection margin status and R0 en bloc resection in pancreatoduodenectomy outcomes. DESIGN: Retrospective medical record review. SETTING: Mayo Clinic, Rochester, Minnesota. PATIENTS: Patients who underwent pancreatoduodenectomy for pancreatic adenocarcinoma at our institution between January 1, 1981, and December 31, 2007, were identified and their medical records were reviewed. MAIN OUTCOME MEASURE: Median survival times. RESULTS: A total of 617 patients underwent pancreatoduodenectomy. Median survival times after R0 en bloc resection (n = 411), R0 non-en bloc resection (n = 57), R1 resection (n = 127), and R2 resection (n = 22) were 19, 18, 15, and 10 months, respectively (P < .001). A positive resection margin was associated with death (P = .01). No difference in survival time was found between patients undergoing R0 en bloc and R0 resections after reexcision of an initial positive margin (hazard ratio, 1.19; 95% confidence interval, 0.87-1.64; P = .28). CONCLUSIONS: R0 resection remains an important prognostic factor. Achieving R0 status by initial en bloc resection or reexcision results in similar long-term survival.
OBJECTIVE: To assess the effect of R0 resection margin status and R0 en bloc resection in pancreatoduodenectomy outcomes. DESIGN: Retrospective medical record review. SETTING:Mayo Clinic, Rochester, Minnesota. PATIENTS: Patients who underwent pancreatoduodenectomy for pancreatic adenocarcinoma at our institution between January 1, 1981, and December 31, 2007, were identified and their medical records were reviewed. MAIN OUTCOME MEASURE: Median survival times. RESULTS: A total of 617 patients underwent pancreatoduodenectomy. Median survival times after R0 en bloc resection (n = 411), R0 non-en bloc resection (n = 57), R1 resection (n = 127), and R2 resection (n = 22) were 19, 18, 15, and 10 months, respectively (P < .001). A positive resection margin was associated with death (P = .01). No difference in survival time was found between patients undergoing R0 en bloc and R0 resections after reexcision of an initial positive margin (hazard ratio, 1.19; 95% confidence interval, 0.87-1.64; P = .28). CONCLUSIONS: R0 resection remains an important prognostic factor. Achieving R0 status by initial en bloc resection or reexcision results in similar long-term survival.
Authors: Robert M Cannon; Ryan LeGrand; Ryaz B Chagpar; Syed A Ahmad; Rebecca McClaine; Hong Jin Kim; Christopher Rupp; Cliff S Cho; Adam Brinkman; Sharon Weber; Emily R Winslow; David A Kooby; Carrie K Chu; Charles A Staley; Ian Glenn; William G Hawkins; Alexander A Parikh; Nipun B Merchant; Kelly M McMasters; Robert C G Martin; Glenda G Callender; Charles R Scoggins Journal: HPB (Oxford) Date: 2012-01-19 Impact factor: 3.647
Authors: Yaojun Zhang; Adam E Frampton; Patrizia Cohen; Charis Kyriakides; Jan J Bong; Nagy A Habib; Duncan R C Spalding; Raida Ahmad; Long R Jiao Journal: J Gastrointest Surg Date: 2012-08-10 Impact factor: 3.452
Authors: Jean Robert Delpero; Philippe Bachellier; Nicolas Regenet; Yves Patrice Le Treut; François Paye; Nicolas Carrere; Alain Sauvanet; Aurélie Autret; Olivier Turrini; Geneviève Monges-Ranchin; Jean Marie Boher Journal: HPB (Oxford) Date: 2013-03-07 Impact factor: 3.647