The impact of margin status determined by the one-millimeter rule on tumor recurrence and survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

Nitta Takeo; Nakamura Toru; Mitsuhashi Tomoko; Asano Toshimichi; Okamura Keisuke; Tsuchikawa Takahiro; Tamoto Eiji; Murakami Soichi; Noji Takehiro; Kurashima Yo; Ebihara Yuma; Nakanishi Yoshitsugu; Shichinohe Toshiaki; Hirano Satoshi

Title	en The impact of margin status determined by the one-millimeter rule on tumor recurrence and survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma
Creator	en Nitta, Takeo en Nakamura, Toru NRID 1000070645796 en Mitsuhashi, Tomoko NRID 1000060348208 en Asano, Toshimichi en Okamura, Keisuke en Tsuchikawa, Takahiro NRID 1000050507572 en Tamoto, Eiji en Murakami, Soichi en Noji, Takehiro NRID 1000010739296 en Kurashima, Yo NRID 1000040374350 en Ebihara, Yuma NRID 1000050632981 en Nakanishi, Yoshitsugu en Shichinohe, Toshiaki NRID 1000070374353 en Hirano, Satoshi NRID 1000050322813
Accessrights	open access
Rights	en The final publication is available at link.springer.com
Subject	Other en Pancreatic ductal adenocarcinoma Other en Margin Other en 1-mm rule Other en TNM Other en Disease-free survival NDC 490
Description	Abstract en 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: R1^1-mm rule resection was associated with a significantly worse disease-free survival (DFS) than R0^1-mm rule resection (p = 0.0259), while R1^TNM had no impact on DFS. R1^1-mm rule resection margin status correlated with the incidence of tumor recurrence in the liver (p = 0.0483). In a multivariate analysis, R1^1-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.
Publisher	en Springer
Date	Issued2017-04
Language	eng
Resource Type	journal article
Version Type	AM
Identifier	HDL http://hdl.handle.net/2115/68665
Relation	isVersionOf DOI https://doi.org/10.1007/s00595-016-1420-7 PMID 27677294
Journal	PISSN 0941-1291 en Surgery today Volume Number47 Issue Number4 Page Start490 Page End497
File	fulltext SurgToday47_490.pdf 548.26 KB (application/pdf) Issued2017-04
Oaidate	2023-07-26