Delpero J-R, Turrini O
Département de chirurgie, institut Paoli-Calmettes, Marseille, France.
Bull Cancer. 2008 Dec;95(12):1193-8. doi: 10.1684/bdc.2008.0762.
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.
根治性切除（R0）仍然是胰腺导管腺癌唯一可能的治愈性治疗方法。局部区域和远处转移复发很常见。显微镜下切缘受累（R1）率在文献中的差异很大（5%至85%），且R1切除的报道常常不足。尽管十多年来一直呼吁标准化，但目前对于胰十二指肠切除术标本（PDS）的病理检查缺乏质量评估。究竟什么构成最小切缘仍有待确定。应使用标准化的病理检查方案来评估R1切除与临床结局之间的相关性（并非所有研究都观察到这种相关性），以及（新）辅助治疗在临床试验中的效果。一项正在进行的法国多中心方案的目的是，采用标准化的病理检查方案评估法国的R1切除率，以及R1状态对临床结局的影响。
