The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma
Purpose: Pancreatic ductal adenocarcinoma (PADC) still has nowadays a very impaired long-term survival. Most studies are focused on overall survival; however, local recurrence occurs about up to 50% of cases and seems to be highly related with margin resection status. We aim to analyze the impact of...
| Autores: | , , , , |
|---|---|
| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Recursos: | Universitat Pompeu Fabra |
| Repositorio: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/70817 |
| Acesso em linha: | http://hdl.handle.net/10230/70817 http://dx.doi.org/10.1007/s00423-024-03301-3 |
| Access Level: | acceso abierto |
| Palavra-chave: | Margin Pancreatic adenocarcinoma Pancreatoduodenectomy Whipple |
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The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinomaCuesta López, JulioIelpo, BenedettoIglesias Coma, MarBurdío Pinilla, FernandoSánchez Velázquez, Patricia, 1985-MarginPancreatic adenocarcinomaPancreatoduodenectomyWhipplePurpose: Pancreatic ductal adenocarcinoma (PADC) still has nowadays a very impaired long-term survival. Most studies are focused on overall survival; however, local recurrence occurs about up to 50% of cases and seems to be highly related with margin resection status. We aim to analyze the impact of vascular resection margins on local recurrence (LR) and to assess its impact on overall and disease-free survival. Methods: Eighty out of 191 patients who underwent pancreatoduodenectomy in a university hospital between 2006 and 2021 with PDAC diagnosis were analyzed and vascular margin status specifically addressed. Univariate and multivariate were performed. Time to LR was compared by using the Kaplan-Meier method and prognostic factors assessed using Cox regression hazards model. Results: LR appeared in 10 (50%) of the overall R1 resections in the venous margin and 9 (60%) in the arterial one. Time to LR was significantly shorter when any margin was overall affected (23.2 vs 44.7 months, p = 0.01) and specifically in the arterial margin involvement (13.7 vs 32.1 months, p = 0.009). Overall R1 resections (HR 2.61, p = 0.013) and a positive arterial margin (HR 2.84, p = 0.012) were associated with local recurrence on univariate analysis, whereas arterial positive margin remained significant on multivariate analysis (HR 2.70, p = 0.031). Conclusions: Arterial margin invasion is correlated in our cohort with local recurrence. Given the limited ability to modify this margin intraoperatively, preoperative therapies should be considered to improve local margin clearance.Springer202520252024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/70817http://dx.doi.org/10.1007/s00423-024-03301-3reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésLangenbecks Arch Surg. 2024 Apr 12;409(1):122© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/708172026-06-12T07:21:37Z |
| dc.title.none.fl_str_mv |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| title |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| spellingShingle |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma Cuesta López, Julio Margin Pancreatic adenocarcinoma Pancreatoduodenectomy Whipple |
| title_short |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| title_full |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| title_fullStr |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| title_full_unstemmed |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| title_sort |
The impact of vascular margin invasion on local recurrence after pancreatoduodenectomy in pancreatic adenocarcinoma |
| dc.creator.none.fl_str_mv |
Cuesta López, Julio Ielpo, Benedetto Iglesias Coma, Mar Burdío Pinilla, Fernando Sánchez Velázquez, Patricia, 1985- |
| author |
Cuesta López, Julio |
| author_facet |
Cuesta López, Julio Ielpo, Benedetto Iglesias Coma, Mar Burdío Pinilla, Fernando Sánchez Velázquez, Patricia, 1985- |
| author_role |
author |
| author2 |
Ielpo, Benedetto Iglesias Coma, Mar Burdío Pinilla, Fernando Sánchez Velázquez, Patricia, 1985- |
| author2_role |
author author author author |
| dc.subject.none.fl_str_mv |
Margin Pancreatic adenocarcinoma Pancreatoduodenectomy Whipple |
| topic |
Margin Pancreatic adenocarcinoma Pancreatoduodenectomy Whipple |
| description |
Purpose: Pancreatic ductal adenocarcinoma (PADC) still has nowadays a very impaired long-term survival. Most studies are focused on overall survival; however, local recurrence occurs about up to 50% of cases and seems to be highly related with margin resection status. We aim to analyze the impact of vascular resection margins on local recurrence (LR) and to assess its impact on overall and disease-free survival. Methods: Eighty out of 191 patients who underwent pancreatoduodenectomy in a university hospital between 2006 and 2021 with PDAC diagnosis were analyzed and vascular margin status specifically addressed. Univariate and multivariate were performed. Time to LR was compared by using the Kaplan-Meier method and prognostic factors assessed using Cox regression hazards model. Results: LR appeared in 10 (50%) of the overall R1 resections in the venous margin and 9 (60%) in the arterial one. Time to LR was significantly shorter when any margin was overall affected (23.2 vs 44.7 months, p = 0.01) and specifically in the arterial margin involvement (13.7 vs 32.1 months, p = 0.009). Overall R1 resections (HR 2.61, p = 0.013) and a positive arterial margin (HR 2.84, p = 0.012) were associated with local recurrence on univariate analysis, whereas arterial positive margin remained significant on multivariate analysis (HR 2.70, p = 0.031). Conclusions: Arterial margin invasion is correlated in our cohort with local recurrence. Given the limited ability to modify this margin intraoperatively, preoperative therapies should be considered to improve local margin clearance. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024 2025 2025 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
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http://hdl.handle.net/10230/70817 http://dx.doi.org/10.1007/s00423-024-03301-3 |
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http://hdl.handle.net/10230/70817 http://dx.doi.org/10.1007/s00423-024-03301-3 |
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Inglés |
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Inglés |
| dc.relation.none.fl_str_mv |
Langenbecks Arch Surg. 2024 Apr 12;409(1):122 |
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http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by/4.0/ |
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openAccess |
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application/pdf application/pdf |
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Springer |
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Springer |
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reponame:Repositorio Digital de la UPF instname:Universitat Pompeu Fabra |
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Universitat Pompeu Fabra |
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Repositorio Digital de la UPF |
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Repositorio Digital de la UPF |
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