An R0 resection margin does improve overall survival after PDAC resection- real-world evidence from 6.000 cases from the German Cancer Registry Group

被引：0

作者：

von Fritsch, Lennart ^{[1
]}

Duhn, Jannis ^{[1
]}

Abdalla, Thaer S. A. ^{[1
]}

Honselmann, Kim C. ^{[1
]}

Bolm, Louisa ^{[1
]}

Braun, Ruediger ^{[1
]}

Kist, Markus ^{[1
]}

Lapshyn, Hryhoriy ^{[1
]}

Zeissig, Sylke Ruth ^{[2
,3
]}

Klinkhammer-Schalke, Monika ^{[4
,5
]}

van Tol, Kees Kleihues ^{[5
]}

Litkevych, Stanislav ^{[1
]}

Reinwald, Fabian ^{[6
]}

Sackmann, Andrea ^{[7
]}

Franke, Bianca ^{[5
]}

Holleczek, Bernd ^{[8
]}

Krauss, Anna ^{[9
]}

Deichmann, Steffen ^{[1
]}

Keck, Tobias ^{[1
]}

Wellner, Ulrich F. ^{[1
]}

机构：

[1] Univ Med Ctr Schleswig Holstein, Dept Surg, Campus Lubeck,Ratzeburger Allee 160, D-23562 Lubeck, Germany

[2] Univ Wurzburg, Inst Clin Epidemiol & Biometry ICE B, Wurzburg, Germany

[3] Bavarian Canc Registry, Wurzburg, Germany

[4] Univ Regensburg, Regensburg Tumor Ctr, Ctr Qual Assurance & Hlth Care Res, Bavarian Canc Registry, Regensburg, Germany

[5] Assoc German Tumor Ctr ADT, German Canc Registry Grp, Network Care Qual & Res Oncol, Berlin, Germany

[6] Canc Registry Rhineland Palatinate Inst Digital Hl, Mainz, Germany

[7] Hessian Off Hlth & Care, Hessian Canc Registry, Frankfurt, Germany

[8] Saarland Canc Registry, Saarbrucken, Germany

[9] Univ Med Greifswald, Inst Community Med, Canc Registry Mecklenburg Western Pomerania, Greifswald, Germany

来源：

EJSO | 2025年 / 51卷 / 06期

关键词：

PDAC; Surgery; R0; Resection margins; Oncology; Cancer; PANCREATIC-CANCER; IMPACT; PANCREATICODUODENECTOMY;

D O I：

10.1016/j.ejso.2025.109693

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: To date surgical resection is the only curative treatment option for pancreatic ductal adenocarcinoma (PDAC). However, survival rates are poor. Resection margins have long been used as a surrogate to evaluate success of the surgery. Their prognostic value and biologic implications remain disputed. Methods: Data was obtained from pooled data of 17 clinical cancer registries in Germany collated by the German Cancer Registry Group of the Association of German Tumor Centers. Overall and disease-free survival (OS/DFS) after 5.997 PDAC resections with documented margin status were analyzed using Kaplan-Meier analyses. Subgroups by type of surgery and lymph node involvement were analyzed. Cox regression for OS and multivariable regression analysis for the endpoint resection margin negative/positive (R0/R1) were performed. Results: Both the median OS (19.3 vs. 13.4 months, R0/R1, respectively) and DFS (14.2 vs. 10.9 months, R0/R1, respectively) were improved for margin negative cases (R0). These differences were also observed after stratifying for lymph node involvement or the type of surgery (pancreas head resection, left resection, or total pancreatectomy). Cox regression revealed a positive margin (R1) to be independently associated with a poor survival (hazard ratio 1.41). Tumor size, perineural invasion, and lymph node involvement were the strongest predictors of a margin-positive resection (R1) in multivariable regression analysis. Conclusion: In this large population-based study, margin status was an independent risk factor for OS and DFS after PDAC resection, even after controlling for confounding factors. Therefore, resection margin is not only a mediator variable between tumor biology and outcome.

引用

页数：7

共 1 条

[1] Different survival outcomes after curative R0-resection for Eastern Asian and European gastric cancer Results from a propensity score matched analysis comparing a Korean and a German specialized center
Kim, Young-Woo
Joo, Jungnam
Yoon, Hong Man
Eom, Bang Wool
Ryu, Keun Won
Choi, Il Ju
Kook, Myeong Cherl
Schuhmacher, Christoph
Siewert, Joerg Ruediger
Reim, Daniel
MEDICINE, 2016, 95 (28)

← 1 →