Wu W G, Wu X S, Li M L, Wang X A, Liang H B, Liu Y B
Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200092, China.
Zhonghua Wai Ke Za Zhi. 2017 Jan 1;55(1):37-40. doi: 10.3760/cma.j.issn.0529-5815.2017.01.010.
Pancreatic ductal adenocarcinoma is a highly aggressive disease with a grim prognosis. Surgical resection offers the best chance for long-term survival. Negative-margin resection still remains the goal, the influence of margin status on outcomes in pancreatic head carcinoma remains controversial, as conflicting data have been plagued by a lack of standardization in R0 resection and margin definitions, pathologic analysis, and reporting. In contrast to common belief, a high rate of R1 resections in pancreatic cancer is not a marker of low-quality surgery but rather of high-quality pathology. The international pathological consensus of pancreatic head carcinoma is still needed to fully understand the prognostic value of margin status in order to optimize treatment strategy for this disease.
胰腺导管腺癌是一种侵袭性很强的疾病,预后很差。手术切除为长期生存提供了最佳机会。切缘阴性切除仍是目标,然而,切缘状态对胰头癌预后的影响仍存在争议,因为相互矛盾的数据一直受到R0切除和切缘定义、病理分析及报告缺乏标准化的困扰。与普遍看法相反,胰腺癌中高比例的R1切除并非低质量手术的标志,而是高质量病理的标志。仍需要胰腺头癌的国际病理共识来充分了解切缘状态的预后价值,以便优化该疾病的治疗策略。