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Gebauer, Florian; Tachezy, Michael; Vashist, Yogesh K.; Marx, Andreas H.; Yekebas, Emre; Izbicki, Jakob R.; Bockhorn, Maximilian

Resection Margin Clearance in Pancreatic Cancer After Implementation of the Leeds Pathology Protocol (LEEPP): Clinically Relevant or Just Academic?

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  • Medientyp: E-Artikel
  • Titel: Resection Margin Clearance in Pancreatic Cancer After Implementation of the Leeds Pathology Protocol (LEEPP): Clinically Relevant or Just Academic?
  • Beteiligte: Gebauer, Florian; Tachezy, Michael; Vashist, Yogesh K.; Marx, Andreas H.; Yekebas, Emre; Izbicki, Jakob R.; Bockhorn, Maximilian
  • Erschienen: Wiley, 2015
  • Erschienen in: World Journal of Surgery
  • Sprache: Englisch
  • DOI: 10.1007/s00268-014-2808-4
  • ISSN: 0364-2313; 1432-2323
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background and objectives</jats:title><jats:p>The aim of this study was to assess the overall survival (OS) after R0/R1 resections in patients with pancreatic ductal adenocarcinoma (PDAC) of the pancreatic head after implementation of a standardized histopathologic protocol (Leeds Pathology Protocol, LEEPP).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>One hundred and twenty‐five patients underwent surgical resection because of PDAC of the pancreatic head. Patients were histopathologically examined according to a standardized protocol. Their oncologic outcome and clinicopathologic data were compared with those of a patient group before implementation of the LEEPP (<jats:italic>n</jats:italic> = 116).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The R1 rate increased significantly from 13 to 52 %. There was no significant difference in OS between R0 and R1 resections. The median OS in patients with a tumor clearance of less than 2 mm from the resection margin was 15.1 months (12.1–18.1 months) versus 22.2 months (7.8–36.7 months) (<jats:italic>P</jats:italic> = 0.046). Multivariate analysis revealed a margin clearance or 2 mm and more as an independent prognosticator for OS.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>With applying the LEEPP, there was still no significant correlation between the R‐status and OS in patients with PDAC. However, since a margin clearance of 2 mm or more is a predictive factor for OS, the R1 definition might have to be adapted in PDAC.</jats:p></jats:sec>