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

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

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

Kleeff, Jorg (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England;Martin Luther Univ Halle Wittenberg, Univ Hosp Halle, Dept Surg, Halle, Germany

Halloran, Christopher M. (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England

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Raraty, Michael (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England

Jackson, Richard (författare): Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England

Melling, James (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England

Jones, Owain (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Surg, Liverpool, Merseyside, England

Palmer, Daniel H. (författare): Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England

Cox, Trevor F. (författare): Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England

Smith, Chloe J. (författare): Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England

O'Reilly, Derek A. (författare): Manchester Royal Infirm, Dept Surg, Manchester, Lancs, England

Izbicki, Jakob R. (författare): Univ Hamburg, Dept Surg, Med Inst UKE, Hamburg, Germany

Scarfe, Andrew G. (författare): Univ Alberta, Dept Oncol, Div Med Oncol, Cross Canc Inst 2228, Edmonton, AB, Canada

Valle, Juan W. (författare): The Christie, Dept Med Oncol, Manchester, Lancs, England

McDonald, Alexander C. (författare): Beatson West Scotland Canc Ctr, Dept Med Oncol, Glasgow, Lanark, Scotland

Carter, Ross (författare): Glasgow Royal Infirm, Dept Surg, Glasgow, Lanark, Scotland

Tebbutt, Niall C. (författare): Austin Hlth, Dept Med Oncol, Melbourne, Vic, Australia

Goldstein, David (författare): Univ New South Wales, Prince Wales Hosp, Dept Med Oncol, Sydney, NSW, Australia;Univ New South Wales, Sch Clin, Sydney, NSW, Australia

Padbury, Robert (författare): Flinders Med Ctr, Dept Surg, Adelaide, SA, Australia

Shannon, Jennifer (författare): Nepean Canc Ctr, Dept Med Oncol, Nepean, ON, Australia;Univ Sydney, Sydney, NSW, Australia

Dervenis, Christos (författare): Agia Olga Hosp, Dept Surg, Athens, Greece

Glimelius, Bengt (författare): Uppsala universitet,Experimentell och klinisk onkologi

Deakin, Mark (författare): Univ Hosp North Staffordshire, Dept Surg, Stoke On Trent, Staffs, England

Anthoney, Alan (författare): Univ Leeds, St Jamess Univ Hosp, Div Oncol, Leeds, W Yorkshire, England

Lerch, Markus M. (författare): Univ Med Greifswald, Dept Med A, Greifswald, Germany

Mayerle, Julia (författare): Univ Med Greifswald, Dept Med A, Greifswald, Germany

Olah, Attila (författare): Petz Aladar Hosp, Dept Surg, Gyor, Hungary

Rawcliffe, Charlotte L. (författare): Univ Liverpool, Liverpool Canc Res, UK Canc Trials Unit, Liverpool, Merseyside, England

Campbell, Fiona (författare): Heidelberg Univ, Dept Surg, Heidelberg, Germany

Strobel, Oliver (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Pathol, Liverpool, Merseyside, England

Buechler, Markus W. (författare): Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Dept Pathol, Liverpool, Merseyside, England

Neoptolemos, John P. (författare): 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

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2019
2019
Engelska.
Ingår i: Annals of Surgery. - 0003-4932 .- 1528-1140. ; 269:3, s. 520-529

Relaterad länk:: https://urn.kb.se/re...; visa fler...; https://doi.org/10.1...; visa färre...

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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.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

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

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