R1 resection for pancreatic carcinoma

被引:4
作者
Weber, G. F. [1 ]
Kersting, S. [1 ]
Haller, F. [2 ]
Gruetzmann, R. [1 ]
机构
[1] Univ Klinikum Erlangen, Chirurg Klin, Krankenhausstr 12, D-91054 Erlangen, Germany
[2] Univ Klinikum Erlangen, Pathol Inst, Erlangen, Germany
来源
CHIRURG | 2017年 / 88卷 / 09期
关键词
Multimodal and surgical treatment; Standardized pathological examination; Survival; Arterial vascular resection; Follow-up resection; LONG-TERM SURVIVAL; BLOC VASCULAR RESECTION; DUCTAL ADENOCARCINOMA; MARGIN STATUS; ARTERIAL RESECTION; CANCER; PANCREATICODUODENECTOMY; IMPACT; METAANALYSIS; CLASSIFICATION;
D O I
10.1007/s00104-017-0462-8
中图分类号
R61 [外科手术学];
学科分类号
摘要
Surgery is the only potentially curative therapeutic approach in patients with pancreatic ductal adenocarcinoma (PDAC); however, achieving a negative (R0) resection margin is not always possible. The impact of R1 resection margins on survival rates and treatment options (surgical and multimodal) for intraoperatively and postoperatively identified R1 resection margins. For intraoperatively diagnosed R1 resection margins, a re-resection (e.g. pancreas, main bile duct, stomach, superior mesenteric and portal vein) can be performed to achieve R0 resection margins. Arterial resections and the resection of additional organs are occasionally technically feasible and can be performed in an individual approach. New neoadjuvant and adjuvant treatment strategies have increased the rate of resectable PDAC and have improved the outcome of patients with R0/R1 resected PDACs. An R0 resection is the primary goal of surgery in patients with PDAC as R1 resections are correlated with a poor outcome.
引用
收藏
页码:764 / 770
页数:7
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