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Impact of resection margin distance on survival of pancreatic cancer: A systematic review and meta-analysis

Title
Impact of resection margin distance on survival of pancreatic cancer: A systematic review and meta-analysis
Authors
Kim K.S.Kwon J.Kim K.Chie E.K.
Ewha Authors
김규보
SCOPUS Author ID
김규보scopusscopus
Issue Date
2017
Journal Title
Cancer Research and Treatment
ISSN
1598-2998JCR Link
Citation
vol. 49, no. 3, pp. 824 - 833
Keywords
Meta-analysisPancreatic neoplasmsResection marginSystematic review
Publisher
Korean Cancer Association
Indexed
SCIE; SCOPUS; KCI WOS scopus
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. © 2017 by the Korean Cancer Association.
DOI
10.4143/crt.2016.336
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의학전문대학원 > 의학과 > Journal papers
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