Annals of surgical oncology · 2025
Prognostic Value of a ≥ 1000 μm Posterior Margin After Gerota's Fascia Resection in Distal Pancreatectomy for Resectable Pancreatic Cancer: A Single-Center Retrospective Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Murakami Hisashi, Okubo Satoshi, Kono Kei, Okada Takuma, Matsumura Masaru, Shindoh Junichi, Hashimoto Masaji
Аннотация
BACKGROUND: Radical antegrade modular pancreatosplenectomy (RAMPS) enables posterior dissection along Gerota's fascia, contributing to improved R0 resection rates, lymphadenectomy, and overall survival (OS) in pancreatic body and tail cancers. Although a posterior margin ≥ 1000 μm has been associated with better prognosis, its relative impact compared with Gerota's fascia resection remains unclear. This study evaluated whether securing a posterior margin ≥ 1000 μm improves outcomes in patients undergoing Gerota's fascia resection for pancreatic body and tail cancer.
METHODS: This retrospective study included 93 patients who underwent distal pancreatectomy with Gerota's fascia resection for resectable pancreatic cancer without adrenal or kidney invasion (2014-2022). Clinical data, recurrence-free survival (RFS), and OS were compared between patients with posterior margins < 1000 μm and ≥ 1000 μm. Multivariate regression analysis identified independent predictors of recurrence.
RESULTS: Of 93 patients, 21 (23%) had posterior margins < 1000 μm and 72 (77%) had margins ≥ 1000 μm. OS and recurrence rates at 1, 3, and 5 years were comparable between the < 1000 μm and ≥ 1000 μm groups, with no significant differences (OS: 85%, 63%, 51% vs. 93%, 68%, 53%, p = 0.65; recurrence: 7.0%, 33.5%, 59.1% vs. 19.0%, 44.4%, 66.6%, p = 0.30). Multivariate analysis identified four or more positive lymph nodes, splenic vessel invasion, and elevated tumor markers as independent recurrence risk factors.
CONCLUSIONS: In resectable pancreatic cancer without adrenal or kidney invasion, a posterior margin ≥ 1000 μm was not associated with improved survival, supporting the adequacy of this approach. Further investigation into systemic disease control via preoperative chemotherapy is warranted.
METHODS: This retrospective study included 93 patients who underwent distal pancreatectomy with Gerota's fascia resection for resectable pancreatic cancer without adrenal or kidney invasion (2014-2022). Clinical data, recurrence-free survival (RFS), and OS were compared between patients with posterior margins < 1000 μm and ≥ 1000 μm. Multivariate regression analysis identified independent predictors of recurrence.
RESULTS: Of 93 patients, 21 (23%) had posterior margins < 1000 μm and 72 (77%) had margins ≥ 1000 μm. OS and recurrence rates at 1, 3, and 5 years were comparable between the < 1000 μm and ≥ 1000 μm groups, with no significant differences (OS: 85%, 63%, 51% vs. 93%, 68%, 53%, p = 0.65; recurrence: 7.0%, 33.5%, 59.1% vs. 19.0%, 44.4%, 66.6%, p = 0.30). Multivariate analysis identified four or more positive lymph nodes, splenic vessel invasion, and elevated tumor markers as independent recurrence risk factors.
CONCLUSIONS: In resectable pancreatic cancer without adrenal or kidney invasion, a posterior margin ≥ 1000 μm was not associated with improved survival, supporting the adequacy of this approach. Further investigation into systemic disease control via preoperative chemotherapy is warranted.