PURPOSE: The tumor-node-metastasis (TNM) classification defines R1 as the presence of tumor cells at the resection margin, while the current Royal College of Pathologists guidelines for pancreaticoduodenectomy specimens regard the presence of tumor cells within 1 mm from the resection margin as R1 (the "1-mm rule"). The aims of this study were to investigate the resection margin status of pancreatic head cancer retrospectively according to both the TNM and 1-mm rule classifications, and to evaluate the postoperative survival and tumor recurrence patterns. METHODS: A total of 117 patients with pancreatic head cancer were the subjects of this study. RESULTS: R11-mm rule resection was associated with a significantly worse disease-free survival (DFS) than R01-mm rule resection (p = 0.0259), while R1TNM had no impact on DFS. R11-mm rule resection margin status correlated with the incidence of tumor recurrence in the liver (p = 0.0483). In a multivariate analysis, R11-mm rule resection was the independent variable for predicting poor DFS (hazard ratio 1.71; p = 0.0289). CONCLUSIONS: R1 resection margin status determined by the 1-mm rule may be an independent indicator for predicting disease recurrence, especially liver metastasis. These results may be useful for selecting the appropriate adjuvant therapy protocol and conducting strict surveillance in PDAC patients.
PURPOSE: The tumor-node-metastasis (TNM) classification defines R1 as the presence of tumor cells at the resection margin, while the current Royal College of Pathologists guidelines for pancreaticoduodenectomy specimens regard the presence of tumor cells within 1 mm from the resection margin as R1 (the "1-mm rule"). The aims of this study were to investigate the resection margin status of pancreatic head cancer retrospectively according to both the TNM and 1-mm rule classifications, and to evaluate the postoperative survival and tumor recurrence patterns. METHODS: A total of 117 patients with pancreatic head cancer were the subjects of this study. RESULTS: R11-mm rule resection was associated with a significantly worse disease-free survival (DFS) than R01-mm rule resection (p = 0.0259), while R1TNM had no impact on DFS. R11-mm rule resection margin status correlated with the incidence of tumor recurrence in the liver (p = 0.0483). In a multivariate analysis, R11-mm rule resection was the independent variable for predicting poor DFS (hazard ratio 1.71; p = 0.0289). CONCLUSIONS: R1 resection margin status determined by the 1-mm rule may be an independent indicator for predicting disease recurrence, especially liver metastasis. These results may be useful for selecting the appropriate adjuvant therapy protocol and conducting strict surveillance in PDAC patients.
Authors: Irene Esposito; Jörg Kleeff; Frank Bergmann; Caroline Reiser; Esther Herpel; Helmut Friess; Peter Schirmacher; Markus W Büchler Journal: Ann Surg Oncol Date: 2008-03-20 Impact factor: 5.344
Authors: Bettina M Rau; Katharina Moritz; Sarah Schuschan; Guido Alsfasser; Friedrich Prall; Ernst Klar Journal: Surgery Date: 2012-07-03 Impact factor: 3.982
Authors: M S Janot; S Kersting; O Belyaev; A Matuschek; A M Chromik; D Suelberg; W Uhl; A Tannapfel; U Bergmann Journal: Langenbecks Arch Surg Date: 2012-06-14 Impact factor: 3.445
Authors: C Max Schmidt; Emilie S Powell; Constantin T Yiannoutsos; Thomas J Howard; Eric A Wiebke; Chad A Wiesenauer; Joel A Baumgardner; Oscar W Cummings; Lewis E Jacobson; Thomas A Broadie; David F Canal; Robert J Goulet; Eardie A Curie; Higinia Cardenes; John M Watkins; Patrick J Loehrer; Keith D Lillemoe; James A Madura Journal: Arch Surg Date: 2004-07
Authors: Ioannis T Konstantinidis; Andrew L Warshaw; Jill N Allen; Lawrence S Blaszkowsky; Carlos Fernandez-Del Castillo; Vikram Deshpande; Theodore S Hong; Eunice L Kwak; Gregory Y Lauwers; David P Ryan; Jennifer A Wargo; Keith D Lillemoe; Cristina R Ferrone Journal: Ann Surg Date: 2013-04 Impact factor: 12.969
Authors: Fiona Campbell; Richard A Smith; Philip Whelan; Robert Sutton; Michael Raraty; John P Neoptolemos; Paula Ghaneh Journal: Histopathology Date: 2009-09 Impact factor: 5.087
Authors: Asmita Chopra; Mazen Zenati; Melissa E Hogg; Herbert J Zeh; David L Bartlett; Nathan Bahary; Amer H Zureikat; Joal D Beane Journal: Ann Surg Oncol Date: 2021-05-23 Impact factor: 5.344
Authors: Kim C Honselmann; Ilaria Pergolini; Carlos Fernandez-Del Castillo; Vikram Deshpande; David Ting; Martin S Taylor; Louisa Bolm; Motaz Qadan; Ulrich Wellner; Marta Sandini; Dirk Bausch; Andrew L Warshaw; Keith D Lillemoe; Tobias Keck; Cristina R Ferrone Journal: Ann Surg Date: 2019-01-18 Impact factor: 12.969
Authors: William Twengström; Carlos F Moro; Jenny Romell; Jakob C Larsson; Ernesto Sparrelid; Mikael Björnstedt; Hans M Hertz Journal: J Med Imaging (Bellingham) Date: 2022-02-07
Authors: Carl Stephan Leonhardt; Willem Niesen; Eva Kalkum; Rosa Klotz; Thomas Hank; Markus Wolfgang Büchler; Oliver Strobel; Pascal Probst Journal: BJS Open Date: 2022-03-08
Authors: Kim C Honselmann; Ilaria Pergolini; Carlos Fernandez-Del Castillo; Vikram Deshpande; David Ting; Martin S Taylor; Louisa Bolm; Motaz Qadan; Ulrich Wellner; Marta Sandini; Dirk Bausch; Andrew L Warshaw; Keith D Lillemoe; Tobias Keck; Cristina R Ferrone Journal: Ann Surg Date: 2020-08 Impact factor: 13.787
Authors: Thinzar M Lwin; Kentaro Miyake; Takashi Murakami; Jonathan C DeLong; Siamak Amirfakhri; Filemoni Filemoni; Sang Nam Yoon; Paul J Yazaki; John E Shivley; Brian Datnow; Bryan M Clary; Robert M Hoffman; Michael Bouvet Journal: Oncotarget Date: 2018-12-18