Prognostic significance of margin clearance in pancreaticoduodenectomy specimens with pancreatic ductal adenocarcinoma in a Danish population-based nationwide study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Background: In this nationwide population-based cohort study, we investigated the overall minimum margin width that is independently associated with improved survival following pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) and evaluated whether certain margins or surfaces hold independent prognostic significance. Methods: Data from 367 patients who underwent PD for PDAC in the period 2015–2019 were retrieved from the Danish Pancreatic Cancer Database. Missing data were obtained by review of pathology reports and re-microscopy of resection specimens. Surgical specimens were evaluated using a standardised pathological protocol involving multicolour inking, axial slicing and exact reporting of circumferential margin clearances in 0.5 mm increments. Results: When categorised according to margin widths of <0.5, <1.0, <1.5, <2.0, <2.5 and <3.0 mm, R1 resections were detected in 34%, 57%, 75%, 78%, 86% and 87% of cases, respectively. In multivariable analyses, an overall margin clearance of ≥1.5 mm was associated with improved survival compared with a clearance of <1.5 mm (HR 0.70 95% CI 0.51–0.97 (p = 0.031)). When evaluating the margins separately, no margin had independent prognostic significance. Conclusion: Margin clearance of at least 1.5 mm was independently associated with improved survival following PD for PDAC.
Originalsprog | Engelsk |
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Tidsskrift | HPB |
Vol/bind | 25 |
Udgave nummer | 7 |
Sider (fra-til) | 826-835 |
Antal sider | 10 |
ISSN | 1365-182X |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
This project was presented as an oral presentation at the Danish Pathology Society's annual meeting in March 2022 and at the Second Scandinavian Baltic Pancreas Symposium & Second International OPAC Symposium in October 2022. This project was supported by a PhD Scholarship (University of Southern Denmark), a PhD stipend (Region of Southern Denmark) and Odense Pancreas Center (OPAC). The funding sources had no influence in the study protocol, conduction of the study and preparation of the article. The authors declare no conflicts of interest. Data can be made available upon reasonable request.
Funding Information:
This project was presented as an oral presentation at the Danish Pathology Society’s annual meeting in March 2022 and at the Second Scandinavian Baltic Pancreas Symposium & Second International OPAC Symposium in October 2022. This project was supported by a PhD Scholarship (University of Southern Denmark), a PhD stipend (Region of Southern Denmark) and Odense Pancreas Center (OPAC). The funding sources had no influence in the study protocol, conduction of the study and preparation of the article. The authors declare no conflicts of interest. Data can be made available upon reasonable request.
Publisher Copyright:
© 2023 International Hepato-Pancreato-Biliary Association Inc.
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