[HTML][HTML] Impact of resection margin distance on survival of pancreatic cancer: a systematic review and meta-analysis
Cancer research and treatment: official journal of Korean …, 2017•synapse.koreamed.org
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 …
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 …
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 (I 2 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.
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