[Ductal adenocarcinoma of the head of the pancreas: a critical study of R1 resection rates].
Complete resection (R0) remains the only potentially curative treatment of ductal adenocarcinoma of the pancreas. Locoregional and metastatic recurrence is frequent. The rate of microscopic margin involvement (R1) varies markedly in the literature (5 to 85%) and R1 resections are frequently underreported. Despite appeals for standardization over a decade, there is currently a lack of quality assessment for pathological examination of pancreaticoduodenectomy specimens (PDS). What exactly constitutes the minimal clearance remains to be established. A standardized protocol for pathological examination should be used to assess the correlation between R1 resections and clinical outcome (that is not observed in all studies), and the effect of (neo)adjuvant treatment in clinical trials. The aim of an ongoing multicenter French protocol is to evaluate the R1 resections rate in France, with a standardized protocol for pathological examination, and the impact of R1 status on the clinical outcome.
Delpero
J-R
JR
Département de chirurgie, institut Paoli-Calmettes, Marseille, France. jrdelpero@numericable.fr
Turrini
O
O
D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis