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
In recent years, the status of resection margin of patients with pancreatic head carcinoma after pancreaticoduodenectomy (PD) has received much attention, but controversies still exist.
This study aimed to examine the impact of resection margin status on long-term overall survival (OS) of patients with pancreatic head carcinoma after PD.
This study examined the impact of resection margin status on long-term OS of patients with pancreatic head carcinoma after PD by 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 OS 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 OS rates were significantly higher for the patients who underwent R0 resection than 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 resection margin status and venous invasion to be significant risk factors of OS. Future studies should be required to determine the impact of resection margin status on long-term OS of patients with pancreatic head carcinoma after PD in a larger sample population.
This study suggested that patients with R0 resection had significantly better postoperative long-term OS than those with R1 resection. Venous invasion was an independent factor influencing survival. Adequate resection to achieve R0 resection can improve postoperative long-term OS for patients with pancreatic head cancer.
The sample size of this study was small and patients who died of complications in the perioperative period were not included because this study focused only on long-term OS. The follow-up isolation time was also too long in this study, which would affect the accuracy of OS. Future studies will be required to determine the impact of resection margin status on long-term OS of patients with pancreatic head carcinoma after PD in larger sample population.