Scholarlink

Background <p>Radical antegrade modular pancreatosplenectomy (RAMPS) enables posterior dissection along Gerota’s fascia, contributing to improved R0 resection rates, lymphadenectomy, and overall survival (OS) in pancreatic body and tail cancers. Although a posterior margin ≥ 1000&#xa0;μm has been associated with better prognosis, its relative impact compared with Gerota’s fascia resection remains unclear. This study evaluated whether securing a posterior margin ≥ 1000&#xa0;μm improves outcomes in patients undergoing Gerota’s fascia resection for pancreatic body and tail cancer.</p> Methods <p>This retrospective study included 93 patients who underwent distal pancreatectomy with Gerota’s fascia resection for resectable pancreatic cancer without adrenal or kidney invasion (2014–2022). Clinical data, recurrence-free survival (RFS), and OS were compared between patients with posterior margins &lt; 1000&#xa0;μm and ≥ 1000&#xa0;μm. Multivariate regression analysis identified independent predictors of recurrence.</p> Results <p>Of 93 patients, 21 (23%) had posterior margins &lt; 1000&#xa0;μm and 72 (77%) had margins ≥ 1000&#xa0;μm. OS and recurrence rates at 1, 3, and 5&#xa0;years were comparable between the &lt; 1000&#xa0;μm and ≥ 1000&#xa0;μm groups, with no significant differences (OS: 85%, 63%, 51% vs. 93%, 68%, 53%, <i>p </i>= 0.65; recurrence: 7.0%, 33.5%, 59.1% vs. 19.0%, 44.4%, 66.6%, <i>p </i>= 0.30). Multivariate analysis identified four or more positive lymph nodes, splenic vessel invasion, and elevated tumor markers as independent recurrence risk factors.</p> Conclusions <p>In resectable pancreatic cancer without adrenal or kidney invasion, a posterior margin ≥ 1000&#xa0;μm was not associated with improved survival, supporting the adequacy of this approach. Further investigation into systemic disease control via preoperative chemotherapy is warranted.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prognostic Value of a ≥ 1000 μm Posterior Margin After Gerota’s Fascia Resection in Distal Pancreatectomy for Resectable Pancreatic Cancer: A Single-Center Retrospective Study

  • 期刊论文

  • 发表日期：

    2025年9月3日

查看全文
  • Hisashi Murakami,
  • Satoshi Okubo,
  • Kei Kono,
  • Takuma Okada,
  • Masaru Matsumura,
  • Junichi Shindoh,
  • Masaji Hashimoto

摘要

Background

Radical antegrade modular pancreatosplenectomy (RAMPS) enables posterior dissection along Gerota’s fascia, contributing to improved R0 resection rates, lymphadenectomy, and overall survival (OS) in pancreatic body and tail cancers. Although a posterior margin ≥ 1000 μm has been associated with better prognosis, its relative impact compared with Gerota’s fascia resection remains unclear. This study evaluated whether securing a posterior margin ≥ 1000 μm improves outcomes in patients undergoing Gerota’s fascia resection for pancreatic body and tail cancer.

Methods

This retrospective study included 93 patients who underwent distal pancreatectomy with Gerota’s fascia resection for resectable pancreatic cancer without adrenal or kidney invasion (2014–2022). Clinical data, recurrence-free survival (RFS), and OS were compared between patients with posterior margins < 1000 μm and ≥ 1000 μm. Multivariate regression analysis identified independent predictors of recurrence.

Results

Of 93 patients, 21 (23%) had posterior margins < 1000 μm and 72 (77%) had margins ≥ 1000 μm. OS and recurrence rates at 1, 3, and 5 years were comparable between the < 1000 μm and ≥ 1000 μm groups, with no significant differences (OS: 85%, 63%, 51% vs. 93%, 68%, 53%, p = 0.65; recurrence: 7.0%, 33.5%, 59.1% vs. 19.0%, 44.4%, 66.6%, p = 0.30). Multivariate analysis identified four or more positive lymph nodes, splenic vessel invasion, and elevated tumor markers as independent recurrence risk factors.

Conclusions

In resectable pancreatic cancer without adrenal or kidney invasion, a posterior margin ≥ 1000 μm was not associated with improved survival, supporting the adequacy of this approach. Further investigation into systemic disease control via preoperative chemotherapy is warranted.