The impact of resection margin status within 1 mm clearance of portal and superior mesenteric vasculature on the prognosis of patients of pancreatic head adenocarcinoma undergoing pancreatoduodenectomy / 中华普通外科杂志

ABSTRACT

Objective:To evaluate the impact of resection margin status within a cut-off 1 mm clearance of cancer on the groove of portal/superior mesenteric vein and/or the top end of the uncinate process bordering on the superior mesenteric artery in pancreatic head adenocarcinoma patients after pancreatoduodenectomy.Methods:The clinical, pathological and followup data of 113 pancreatic head adenocarcinoma patients undergoing pancreatoduodenectomy with or without vascular graft replacement were retrospectively analyzed.Results:Univariate analysis showed that resection margin 1mm clearance, postoperative adjuvant chemotherapy, T staging, N staging, TNM staging (AJCC), gender, and maximum tumor diameter were risk factors for survival . Multivariate analysis showed that surgical margin 1mm clearance, postoperative adjuvant chemotherapy, and gender were independent prognostic factors. In resection margin >1 mm group(83 cases), the mean survival time was 19.04 months, and the 1-year, 2-year, and 3-year survival rates were 78%, 50%, and 25%, respectively. In resection margin ≤1 mm group(30 cases), the mean survival time was 9.42 months, and the 1-year, 2-year and 3-year survival rates were 61%, 20% and 0, respectively. There was statistical significance between the two groups in survival time ( P=0.018). Conclusion:Resection margins 1 mm clearance of cancer off portal vein/superior mesenteric vein and superior mesenteric artery is independent prognostic factors in pancreatic head adenocarcinoma patients undergoing pancreatoduodenectomy.