The prognostic impact of resection margin status varies according to the genetic and morphological evaluation (GAME) score for colorectal liver metastasis

2021 ◽  
Author(s):  
Hong‐Wei Wang ◽  
Li‐Jun Wang ◽  
Ke‐Min Jin ◽  
Quan Bao ◽  
Juan Li ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Resection Margin ◽  
Margin Status ◽  
Prognostic Impact ◽  
Morphological Evaluation ◽  
Resection Margin Status

scholarly journals Prognostic impact of resection margin status in distal pancreatectomy for ductal adenocarcinoma

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S826-S827
Author(s):  
M. Sahakyan ◽  
C. Verbeke ◽  
T. Tholfsen ◽  
D. Kleive ◽  
T. Buanes ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Resection Margin ◽  
Margin Status ◽  
Ductal Adenocarcinoma ◽  
Prognostic Impact ◽  
Resection Margin Status

scholarly journals Preoperative Chemotherapy and Resection Margin Status in Colorectal Liver Metastasis Patients: A Propensity Score–Matched Analysis

2019 ◽  
Vol 85 (5) ◽  
pp. 488-493
Author(s):  
Leonardo Solaini ◽  
Andrea Gardini ◽  
Alessandro Passardi ◽  
Maria Teresa Mirarchi ◽  
Fabrizio D'Acapito ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Liver Resection ◽  
Liver Metastasis ◽  
Propensity Score ◽  
Preoperative Chemotherapy ◽  
Resection Margin ◽  
Margin Status ◽  
Positive Resection Margin ◽  
Resection Margin Status ◽  
Surgery First

In this article, we compared the early and long-term outcomes of patients with metastatic colorectal cancer treated with chemotherapy followed by resection with those of patients undergoing surgery first, focusing our analysis on resection margin status. Patients who underwent liver resection with curative intent for colorectal liver metastases from July 2001 to January 2018 were included in the analysis. Propensity score matching was used to reduce treatment allocation bias. The cohort comprised 164 patients; 117 (71.3%) underwent liver resection first, whereas the remaining 47 (28.7%) had preoperative chemotherapy. After a 1:1 ratio of propensity score matching, 47 patients per group were evaluated. A positive resection margin was found in 13 patients in the surgery-first group (25.5%) versus 4 (8.5%) in the preoperative chemotherapy group ( P = 0.029). Postmatched logistic regression analysis showed that only preoperative chemotherapy was significantly associated with the rate of positive resection margin (odds ratio 0.24, 95% confidence interval 0.07–0.81; P = 0.022). Median follow-up was 41 months (interquartile range 8–69). Cox proportional hazard regression analysis revealed that only positive resection margin was a significant negative prognostic factor (hazard ratio 2.2, 95% CI 1.18–4.11; P = 0.014). Within the preoperative chemotherapy group, median overall survival was 40 months in R0 patients and 10 months in R1 patients ( P = 0.016). Although preoperative chemotherapy in colorectal liver metastasis patients may affect the rate of positive resection margin, its impact on survival seems to be limited. In the present study, the most important prognostic factor was the resection margin status.

The Prognostic Impact of Determining Resection Margin Status for Multiple Colorectal Metastases According to the Margin of the Largest Lesion

2017 ◽  
Vol 24 (9) ◽  
pp. 2438-2446 ◽  
Author(s):  
Kazunari Sasaki ◽  
Georgios A. Margonis ◽  
Kosuke Maitani ◽  
Nikolaos Andreatos ◽  
Jaeyun Wang ◽  
...  
Keyword(s):  
Resection Margin ◽  
Margin Status ◽  
Colorectal Metastases ◽  
Prognostic Impact ◽  
Resection Margin Status

scholarly journals Prognostic Impact of Resection Margin Status in Distal Pancreatectomy for Ductal Adenocarcinoma

2021 ◽  
Author(s):  
Mushegh A. Sahakyan ◽  
Caroline S. Verbeke ◽  
Tore Tholfsen ◽  
Dejan Ignjatovic ◽  
Dyre Kleive ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Resection Margin ◽  
Margin Status ◽  
Ductal Adenocarcinoma ◽  
Resection Margins ◽  
Prognostic Impact ◽  
Entire Cohort ◽  
Period 2 ◽  
Node Ratio ◽  
Resection Margin Status

Abstract Background Resection margin status is considered one of the few surgeon-controlled parameters affecting prognosis in pancreatic ductal adenocarcinoma (PDAC). While studies mostly focus on resection margins in pancreatoduodenectomy, little is known about their role in distal pancreatectomy (DP). This study aimed to investigate resection margins in DP for PDAC. Methods Patients who underwent DP for PDAC between October 2004 and February 2020 were included (n = 124). Resection margins and associated parameters were studied in two consecutive time periods during which different pathology examination protocols were used: non-standardized (period 1: 2004–2014) and standardized (period 2: 2015–2020). Microscopic margin involvement (R1) was defined as ≤1 mm clearance. Results Laparoscopic and open resections were performed in 117 (94.4%) and 7 (5.6%) patients, respectively. The R1 rate for the entire cohort was 73.4%, increasing from 60.4% in period 1 to 83.1% in period 2 (p = 0.005). A significantly higher R1 rate was observed for the posterior margin (35.8 vs. 70.4%, p < 0.001) and anterior pancreatic surface (based on a 0 mm clearance; 18.9 vs. 35.4%, p = 0.045). Pathology examination period, poorly differentiated PDAC, and vascular invasion were associated with R1 in the multivariable model. Extended DP, positive anterior pancreatic surface, lymph node ratio, perineural invasion, and adjuvant chemotherapy, but not R1, were significant prognostic factors for overall survival in the entire cohort. Conclusions Pathology examination is a key determinant of resection margin status following DP for PDAC. A high R1 rate is to be expected when pathology examination is meticulous and standardized. Involvement of the anterior pancreatic surface affects prognosis.

A Systematic Review to Assess Resection Margin Status After Abdominoperineal Excision and Pelvic Exenteration for Rectal Cancer

2017 ◽  
Vol 265 (2) ◽  
pp. 291-299 ◽  
Author(s):  
Constantinos Simillis ◽  
Daniel L. H. Baird ◽  
Christos Kontovounisios ◽  
Nikhil Pawa ◽  
Gina Brown ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Resection Margin ◽  
Pelvic Exenteration ◽  
Abdominoperineal Excision ◽  
Margin Status ◽  
Resection Margin Status

scholarly journals Redefining resection margin status in pancreatic cancer

HPB ◽  
2009 ◽  
Vol 11 (4) ◽  
pp. 282-289 ◽  
Author(s):  
Caroline S. Verbeke ◽  
Krishna V. Menon
Keyword(s):  
Pancreatic Cancer ◽  
Resection Margin ◽  
Margin Status ◽  
Resection Margin Status

Prediction of Residual Neoplasia Based on Pathologic Severity and Resection Margin Status of Conization Specimens

1998 ◽  
Vol 9 (1) ◽  
pp. 29
Author(s):  
Chang Soo Park ◽  
Jong Taek Moon ◽  
Jong Dae Whang ◽  
In Sook Joo ◽  
Sang Yong Song ◽  
...  
Keyword(s):  
Resection Margin ◽  
Margin Status ◽  
Resection Margin Status

P96 THE CURRENT ROLE OF ADJUVANT THERAPY IN PATIENTS FOLLOWING NEO-ADJUVANT CHEMOTHERAPY AND R0 RESECTION FOR LOWER OESOPHAGEAL AND GOJ ADENOCARCINOMA

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
R Bott ◽  
J Zylstra ◽  
M Wilkinson ◽  
W Knight ◽  
C Baker ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Survival Benefit ◽  
Resection Margin ◽  
Margin Status ◽  
R0 Resection ◽  
Resection Margin Status ◽  
Neo Adjuvant Chemotherapy

Abstract Aim  The aim of this study was to assess the survival benefit of adjuvant therapy in R0 resection patients following neo-adjuvant chemotherapy and surgery for lower oesophageal and GOJ adenocarcinoma. Background & Methods  The role of adjuvant therapy in oesophago-gastric adenocarcinoma patients treated by neo-adjuvant chemotherapy is contentious. In UK practice surgical resection margin status is often used to stratify patients into receiving adjuvant treatment. Two prospectively collected institutional databases were combined. Patients were classified by the adjuvant therapy received. Crude and adjusted Cox regression analyses compared overall and recurrence free survival according to the adjuvant treatment, stratified by resection margin status. Recurrence patterns were assessed as a secondary outcome. Results  A total of 616 patients were included (373 R0, 243 R1). In hospital mortality following surgery was 1% and these patients were excluded from analysis (n=7). In the R0 resection group 220 patients (59%) had no adjuvant treatment and 137 patients (37%) had adjuvant chemotherapy. On adjusted analysis pathological N status (p<0.0001), poor differentiation (p=0.005) and poor response to neo-adjuvant chemotherapy (p=0.001) were independently associated with poor survival. The benefit of adjuvant chemotherapy did not reach independent significance (HR 0.65 95% CI 0.40-1.06; p=0.087) compared to no treatment. However, it was observed that responders to neo-adjuvant chemotherapy (Mandard 1-3) were more likely to demonstrate a survival benefit from adjuvant chemotherapy (HR 0.42 95%CI 0.15-1.11; p=0.081) than those who are deemed to be non-responders (Mandard 4&5, HR 0.71 95%CI 0.39-1.32; p= 0.280). Conclusion  Adjuvant chemotherapy may have a survival benefit in R0 resection patients following surgery, but this is likely to be limited to patients exhibiting a good response to neo-adjuvant chemotherapy.

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