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  • Ghaneh, PaulaUniv Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England;Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England (författare)

The Impact of Positive Resection Margins on Survival and Recurrence Following Resection and Adjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma

  • Artikel/kapitelEngelska2019

Förlag, utgivningsår, omfång ...

  • 2019
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-383878
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-383878URI
  • https://doi.org/10.1097/SLA.0000000000002557DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Objective and Background: Local and distant disease recurrence are frequently observed following pancreatic cancer resection, but an improved understanding of resection margin assessment is required to aid tailored therapiesMethods: Analyses were carried out to assess the association between clinical characteristics and margin involvement as well as the effects of individual margin involvement on site of recurrence and overall and recurrence-free survival using individual patient data from the European Study Group for Pancreatic Cancer (ESPAC)-3 randomized controlled trial.Results: There were 1151 patients, of whom 505 (43.9%) had an RI resection. The median and 95% confidence interval (CI) overall survival was 24.9 (22.9-27.2) months for 646 (56.1%) patients with resection margin negative R0 >1 mm) tumors, 25.4 (21.6 30.4) months for 146 (12.7%) patients with RI <1 mm positive resection margins, and 18.7 (17.2-21.1) months for 359 (31.2%) patients with R1-direct positive margins (P < 0.001). In multivariable analysis, overall R 1-direct tumor margins, poor tumor differentiation, positive lymph node status, WHO performance status ≥ 1, maximum tumor size, and RI-direct posterior resection margin were all independently significantly associated with reduced overall and recurrence-free survival. Competing risks analysis showed that overall R1-direct positive resection margin status, positive lymph node status. WHO performance status 1, and R1-direct positive superior mesenteric/medial margin resection status were all significantly associated with local recurrence.Conclusions: RI-direct resections were associated with significantly reduced overall and recurrence-free survival following pancreatic cancer resection. Resection margin involvement was also associated with an increased risk for local recurrence.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Kleeff, JorgRoyal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England;Martin Luther Univ Halle Wittenberg, Univ Hosp Halle, Dept Surg, Halle, Germany (författare)
  • Halloran, Christopher M.Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England (författare)
  • Raraty, MichaelRoyal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England (författare)
  • Jackson, RichardUniv Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England (författare)
  • Melling, JamesRoyal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England (författare)
  • Jones, OwainRoyal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England (författare)
  • Palmer, Daniel H.Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England (författare)
  • Cox, Trevor F.Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England (författare)
  • Smith, Chloe J.Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England (författare)
  • O'Reilly, Derek A.Manchester Royal Infirm, Dept Surg, Manchester, Lancs, England (författare)
  • Izbicki, Jakob R.Univ Hamburg, Dept Surg, Med Inst UKE, Hamburg, Germany (författare)
  • Scarfe, Andrew G.Univ Alberta, Dept Oncol, Div Med Oncol, Cross Canc Inst 2228, Edmonton, AB, Canada (författare)
  • Valle, Juan W.The Christie, Dept Med Oncol, Manchester, Lancs, England (författare)
  • McDonald, Alexander C.Beatson West Scotland Canc Ctr, Dept Med Oncol, Glasgow, Lanark, Scotland (författare)
  • Carter, RossGlasgow Royal Infirm, Dept Surg, Glasgow, Lanark, Scotland (författare)
  • Tebbutt, Niall C.Austin Hlth, Dept Med Oncol, Melbourne, Vic, Australia (författare)
  • Goldstein, DavidUniv New South Wales, Prince Wales Hosp, Dept Med Oncol, Sydney, NSW, Australia;Univ New South Wales, Sch Clin, Sydney, NSW, Australia (författare)
  • Padbury, RobertFlinders Med Ctr, Dept Surg, Adelaide, SA, Australia (författare)
  • Shannon, JenniferNepean Canc Ctr, Dept Med Oncol, Nepean, ON, Australia;Univ Sydney, Sydney, NSW, Australia (författare)
  • Dervenis, ChristosAgia Olga Hosp, Dept Surg, Athens, Greece (författare)
  • Glimelius, BengtUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)bengglim (författare)
  • Deakin, MarkUniv Hosp North Staffordshire, Dept Surg, Stoke On Trent, Staffs, England (författare)
  • Anthoney, AlanUniv Leeds, St Jamess Univ Hosp, Div Oncol, Leeds, W Yorkshire, England (författare)
  • Lerch, Markus M.Univ Med Greifswald, Dept Med A, Greifswald, Germany (författare)
  • Mayerle, JuliaUniv Med Greifswald, Dept Med A, Greifswald, Germany (författare)
  • Olah, AttilaPetz Aladar Hosp, Dept Surg, Gyor, Hungary (författare)
  • Rawcliffe, Charlotte L.Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England (författare)
  • Campbell, FionaHeidelberg Univ, Dept Surg, Heidelberg, Germany (författare)
  • Strobel, OliverRoyal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Pathol, Liverpool, Merseyside, England (författare)
  • Buechler, Markus W.Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Pathol, Liverpool, Merseyside, England (författare)
  • Neoptolemos, John P.Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England;Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England;Heidelberg Univ, Dept Surg, Heidelberg, Germany (författare)
  • Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England;Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, EnglandRoyal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England;Martin Luther Univ Halle Wittenberg, Univ Hosp Halle, Dept Surg, Halle, Germany (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Annals of Surgery269:3, s. 520-5290003-49321528-1140

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