Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4186
Peer-review started: September 5, 2019
First decision: October 24, 2019
Revised: October 31, 2019
Accepted: November 20, 2019
Article in press: November 20, 2019
Published online: December 26, 2019
Processing time: 110 Days and 23.5 Hours
The impact of resection margin status on long-term survival after pancreaticoduodenectomy (PD) for patients with pancreatic head carcinoma remains controversial and depends on the method used in the histopathological study of the resected specimens. This study aimed to examine the impact of resection margin status on the long-term overall survival of patients with pancreatic head carcinoma after PD using the tumor node metastasis standard.
Consecutive patients with pancreatic head carcinoma who underwent PD at the Chinese People's Liberation Army General Hospital between May 2010 and May 2016 were included. The impact of resection margin status on long-term survival was retrospectively analyzed.
Among the 124 patients, R0 resection was achieved in 85 patients (68.5%), R1 resection in 38 patients (30.7%) and R2 resection in 1 patient (0.8%). The 1- and 3-year overall survival (OS) rates were significantly higher for the patients who underwent R0 resection than the rates for those who underwent R1 resection (1-year OS rates: 69.4% vs 53.0%; 3-year OS rates: 26.9% vs 11.7%). Multivariate analysis showed that resection margin status and venous invasion were significant risk factors for OS.
Resection margin was an independent risk factor for OS for patients with pancreatic head carcinoma after PD. R0 resection was associated with significantly better OS after surgery.
Core tip: This study aimed to examine the impact of resection margin status on the long-term overall survival of patients with pancreatic head carcinoma after pancreaticoduodenectomy using the tumor node metastasis standard. We found the resection margin was an independent risk factor for overall survival for patients with pancreatic head carcinoma after pancreaticoduodenectomy. R0 resection was associated with significantly better overall survival after surgery. It is suggested that surgeons should perform radical resection for patients with pancreatic head cancer as much as possible.