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Impact of Resection Margin Distance on Survival of Pancreatic Cancer: A Systematic Review and Meta-Analysis / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment ; : 824-833, 2017.
Article in English | WPRIM | ID: wpr-129222
ABSTRACT

PURPOSE:

While curative resection is the only chance of cure in pancreatic cancer, controversies exist about the impact of surgical margin status on survival. Non-standardized pathologic report and different criteria on the R1 status made it difficult to implicate adjuvant therapy after resection based on the margin status. We evaluated the influence of resection margins on survival by meta-analysis. MATERIALS AND

METHODS:

We thoroughly searched electronic databases of PubMed, EMBASE, and Cochrane Library. We included studies reporting survival outcomes with different margin status involved margin (R0 mm), margin clearance with ≤ 1 mm (R0-1 mm), and margin with > 1 mm (R>1 mm). Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis.

RESULTS:

A total of eight retrospective studies involving 1,932 patients were included. Pooled HR for overall survival showed that patients with R>1 mm had reduced risk of death than those with R0-1 mm (HR, 0.74; 95% confidence interval [CI], 0.61 to 0.88; p=0.001). In addition, patients with R0-1 mm had reduced risk of death than those with R0 mm (HR, 0.81; 95% CI, 0.72 to 0.91; p < 0.001). There was no heterogeneity between the included studies (I2 index, 42% and 0%; p=0.10 and p=0.82, respectively).

CONCLUSION:

Our results suggest that stratification of the patients based on margin status is warranted in the clinical trials assessing the role of adjuvant treatment for pancreatic cancer.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pancreatic Neoplasms / Population Characteristics / Retrospective Studies Type of study: Observational study / Prognostic study / Systematic reviews Limits: Humans Language: English Journal: Cancer Research and Treatment Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pancreatic Neoplasms / Population Characteristics / Retrospective Studies Type of study: Observational study / Prognostic study / Systematic reviews Limits: Humans Language: English Journal: Cancer Research and Treatment Year: 2017 Type: Article