The Importance of Resection Margin Status in Pancreatic Surgery

1. R0: 62.4 months

2. R1< 1mm from margin: 24.6 months

3. R1 direct: 17.2 monthsPostoperative chemotherapy group median survival

4. R0: 68.6 months

5. R1< 1mm from margin: 32.8 months

6. R1 direct: 21.4 monthsAn important aspect of the study was that the authors not only analyzed the survival rates of all patients but also studied trends of survival in patients who received postoperative chemotherapy. Since postoperative chemotherapy is known to be related with survival, the authors wanted to demonstrate that margin status was independently associated with improved survival. The results of the study confirm the importance of resection margin as they independently predicted survival in these patients regardless of their postoperative chemotherapy status. In particular, the survival benefit of clean resection margins beyond 1mm are highlighted. The differences observed in all reported median survivals were statistically significant. Note: published data suggests that the same findings hold true for Whipple procedures. In short, R0 resections are associated with improved survival of all pancreatic adenocarcinomas, regardless of pancreatic surgery type. You can read the entire article here. Summary by: Michael J. Wright, Department of Surgery, Johns Hopkins School of Medicine