The mesopancreas is the primary site for R1 resection in pancreatic head cancer: relevance for clinical trials.
The mesopancreas is the primary site for R1 resection in pancreatic head cancer: relevance for clinical trials.
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DOI：
10.1007/s00423-009-0494-8
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发表时间：
2010-04
影响因子：
2.3
通讯作者：
Ghadimi, B. M.
中科院分区：
文献类型：
--
作者：
Gaedcke, J.;Gunawan, B.;Grade, M.;Szoeke, R.;Liersch, T.;Becker, H.;Ghadimi, B. M.
胰腺癌患者的预后仍然很差，即使在潜在的治愈性R 0切除术后。这种差异可能是由于过去将R1病例误分类为根治性切除（R 0）。为了检验这一假设，对所有切除边缘和器官表面进行颜色编码，作为标准化组织病理学检查的一部分，并对100个胰头标本进行前瞻性测试。由于病理组织学诊断，35例患者被排除在分析之外;仅包括胰腺导管腺癌、远端胆管腺癌和壶腹周围腺癌。按国际抗癌联合会的标准，32例（49.2%）为R 0级，33例（50.8%）为R1级。在33例R1切除标本中，22例（66.6%）中胰腺被浸润。17例（51.5%）为唯一的肿瘤浸润部位。应用皇家病理学家学会的标准，46例切除被分类为R1（70.8%）。正如预期的那样，胰腺中再次成为最常见的非治愈性切除部位（n = 27; 58.7%）。对胰头癌标本进行强化的组织病理学检查导致R1切除率增加，而中胰腺是阳性切除边缘的主要部位。这些结果与临床试验中的患者分层相关。
The prognosis of patients with pancreatic cancer remains poor, even after potentially curative R0 resection. This discrepancy may be due to the histopathological misclassification of R1 cases as curative resections (R0) in the past. To test this hypothesis, color coding of all resection margins and organ surfaces as part of a standardized histopathological workup was implemented and prospectively tested on 100 pancreatic head specimens. Thirty-five patients were excluded from the analysis owing to the pathohistological diagnosis; only pancreatic ductal adenocarcinoma, distal bile duct adenocarcinoma, and periampullary adenocarcinoma were included. Applying the International Union Against Cancer criteria, 32 cancer resections were classified R0 (49.2%), while 33 cases turned out to be R1 resections (50.8%). The mesopancreas was infiltrated in 22 of the 33 R1 resection specimens (66.6%). It proved to be the only site of tumor infiltration in 17 specimens (51.5%). Applying the Royal College of Pathologists’ criteria, 46 resections were classified R1 (70.8%). As expected, the mesopancreas again was the most frequent site of noncurative resection (n = 27; 58.7%). Using the intensified histopathological workup for pancreatic head cancer specimens resulted in an increased rate of R1 resections and the mesopancreas represents the primary site for positive resection margins. Such results are of relevance for patients’ stratification in clinical trials.
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DOI：
10.1016/j.jamcollsurg.2007.06.332
发表时间：
2007-10-01
影响因子：
5.2
作者：
Buechler, Markus W.;Kleeff, Joerg;Friess, Helmut
通讯作者：
Friess, Helmut
影响因子：
3.2
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Gladhaug IP
影响因子：
9
作者：
Yeo, CJ;Cameron, JL;Abrams, RA
通讯作者：
Abrams, RA
影响因子：
--
作者：
Schmidt, CM;Powell, ES;Madura, JA
通讯作者：
Madura, JA