HPB Surgical Unit, Department of Surgery & Cancer, Imperial College, Hammersmith Hospital campus, Du Cane Road, London, W12 0HS, UK.
Future Oncol. 2013 Jan;9(1):31-4. doi: 10.2217/fon.12.175.
Evaluation of: Gnerlich JL, Luka SR, Deshpande AD et al. Microscopic margins and patterns of treatment failure in resected pancreatic adenocarcinoma. Arch. Surg. 147(8), 753-760 (2012). Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with one of the worst 5-year survival rates of any malignancy. Even after potentially curative surgical resection, disease may progress rapidly. It is therefore important to identify clinicopathologic factors that influence survival and may be modified to improve outcomes. The evaluated article presents data from a retrospective review of patients who underwent surgical resection for PDAC. Local recurrence (LR), distant recurrence and survival were compared between patients with a negative resection margin (R0) and those with a positive resection margin (R1). Patients with R1 posterior margins, in particular, were more likely to have LR and worse LR-free survival. In addition, this was more pronounced if patients had lymph-node involvement. Similar results have been reported in other studies and this study illustrates that standardized pathological reporting of PDAC specimens may allow further investigation of factors affecting R1 patients.
Gnerlich JL、Luka SR、Deshpande AD 等人。切除的胰腺导管腺癌中微观边缘和治疗失败模式。《外科学文献集》147(8)，753-760(2012)。胰腺导管腺癌(PDAC)是一种毁灭性疾病，其 5 年生存率是所有恶性肿瘤中最差的之一。即使进行了潜在的治愈性手术切除，疾病也可能迅速进展。因此，识别影响生存的临床病理因素并加以修改以改善预后非常重要。评估的文章提供了对接受 PDAC 手术切除的患者进行回顾性审查的数据。在 R0 组（阴性切缘）和 R1 组（阳性切缘）患者之间比较局部复发（LR）、远处复发和生存情况。特别是 R1 后缘患者更有可能发生 LR 且 LR 无复发生存率更差。此外，如果患者有淋巴结受累，这种情况更为明显。其他研究也报道了类似的结果，本研究表明，PDAC 标本的标准化病理报告可能允许进一步研究影响 R1 患者的因素。
