Relevance of Positive Resection Margins in Ductal Pancreatic Adenocarcinoma and Prognostic Factors
Juan OcañaAlfonso SanjuánbenitoAlba GarcíaJosé Manuel MolinaEduardo LisaElena MendíaCristina SaavedraEduardo Lobo
3
Citation
33
Reference
10
Related Paper
Citation Trend
Keywords:
Relevance
Pancreatic carcinoma
Resection margin
Margin (machine learning)
An R0 margin width of 1 cm has traditionally been considered a prerequisite to minimize local recurrence and optimize survival following hepatic resection for metastatic colorectal cancer. However, recent data have called into question the prognostic importance of the '1-cm rule'. Specifically, several studies have noted that, although an R0 resection is important, the actual margin width may not be as critical. We provide a brief overview of the impact of an R1 vs. an R0 resection on local recurrence and overall survival. In addition, we specifically review the impact of margin width in patients who have undergone an R0 resection. Finally, we highlight those factors most associated with an increased likelihood of an R1 resection and provide recommendations for avoiding and dealing with microscopic carcinoma discovered intraoperatively at the cut parenchymal transection margin.
Margin (machine learning)
Resection margin
Parenchyma
Surgical margin
Cite
Citations (73)
We approached the issue of surgical margins in the conservative treatment of breast cancer by examining the literature germane to four precise questions: At what distance from the macroscopic margin of the tumour should the resection margin be? To what extent do histologically clear resection margins indicate complete local control of the disease? To what extent do histologically involved margins indicate persistence of disease? and Does the local recurrence rate correlate with the status of the resection margin? We propose categorizing margin involvement into five groups (absent, focal, minimal, moderate and extensive involvement) according to strict histological criteria, and assigning increasingly aggressive subsequent treatments according to the extent of any margin involvement.
Margin (machine learning)
Conservative Treatment
Resection margin
Cite
Citations (19)
Margin (machine learning)
Surgical resection
Resection margin
Surgical margin
Cite
Citations (38)
Objective To investigate the expression of High mobility group box 1(HMGB1) in human pancreatic carcinoma and to explore its relationship to differentiation degree,the size,invasion and metastasis of human pancreatic carcinoma.Methods Immunohistochemical SABC method was used to detect the expression of HMGB1 in 73 pancreatic cancer tissues,10 juxtacancerous tissues and 6 normal pancreatic tissues.Results The positive expression rates of HMGB1 were 76.7%(56/73) in pancreatic cancer and 20.0%(2/10) in juxtacancerous tissue,showing a significant difference(P0.01).The expression of HMGB1 was markedly correlated to tumor size,invasion and metastasis of pancreatic cancer(P0.01),but had no relationship with the differentiation degree(P0.05).Conclusion The strong expression of HMGB1 in pancreatic cancer might be as one of the parameters for determining tumor invasion,metastasis,and prognosis.
HMGB1
Pancreatic carcinoma
CA19-9
High-mobility group
Cite
Citations (3)
Pancreatic Intraepithelial Neoplasia
Pancreatic carcinoma
Cite
Citations (0)
Pancreatic Ductal Adenocarcinoma (PDAC) represents 90% of all pancreatic malignancies . To date, PDAC is the fourth leading cause of cancer-related death and its incidence is rising to become the second one in the next decade
Mesothelin
Pancreatic carcinoma
Cite
Citations (0)
Background: Resection margin status is the most important prognostic factor in resected perihilar cholangiocarcinoma (pCCA).Although the impact of ductal margin (DM) was reported in many studies, the influence of radial margin (RM) is unclear.This study aims to investigate the incidence and the effect of positive RM on survival.Methods: Patients with pCCA who underwent curative resection between October 2013 to December 2018 were retrospectively reviewed.Resection margin status were divided into negative resection margin (R0) and positive resection margin (R1); positive RM alone (RM+) and positive DM with or without positive RM (DM+).Results: Of the 170 pCCA patients, 63 (37%) had R1 margin.Among 63 R1 patients; 18 (28.6%)had positive DM alone, 20 (31.7%) had positive RM alone and 25 (39.7%) had both positive DM and RM.The R1 patients had a significantly greater number of LN metastases and advanced tumor staging than R0 patients, however, there was no difference between the RM+ and DM+ patients.In contrast, the RM+ patients had more combined vascular resection than the DM+ patients.The median survival time of patients with RM+ was significantly poorer than R0 patients (13.8 vs. 24.7 months; p < 0.001, respectively) and similar to the DM+ patients (9.1 months, p = 0.561).In multivariable analysis, positive resection margin and LN metastasis were independent prognostic factors.Conclusions: Positive resection margin remains the most important prognostic factors and positive RM is common in these patients.Positive RM also had a comparable effect on survival as positive DM.As a result, in pCCA, surgical resection should target both RM and DM.
Margin (machine learning)
Resection margin
Cite
Citations (0)
Supplementary Figure 1 from Notch1 Functions as a Tumor Suppressor in a Model of K-ras–Induced Pancreatic Ductal Adenocarcinoma
Pancreatic carcinoma
Cite
Citations (0)
Pancreatic carcinoma
Cite
Citations (1)
<p>PDF file - 243K, Supervised average linkage clustering with centred Pearson correlation using 48 PDACs and 10 normal pancreatic samples. miRNAs are in rows with the samples in columns. The non-tumor normal pancreatic samples are on the right highlighted in green, with the tumor samples highlighted in blue. The expression color bar is shown below the dendrogram. Red indicates a miRNA expression value higher than the average expression across all samples, while blue indicates a lower expression value.</p>
Pancreatic carcinoma
Dendrogram
Value (mathematics)
Expression (computer science)
Cite
Citations (0)