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

Purpose: 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 pancreatoduodenectomy, little known about their role distal pancreatectomy (DP). This study aimed to investigate DP for PDAC. Method: Patients who underwent PDAC between October 2004 and February 2020 were included (n=124). associated studied two consecutive time periods during which different pathology examination protocols used: non-standardized (period 1: 2004-2014) standardized 2: 2015-2020). Microscopic involvement (R1) was defined as ≤ 1mm clearance. Result: Laparoscopic open resections performed 117 (94.4%) 7 (5.6%) patients, respectively. The R1-rate entire cohort 73.4% having increased from 60.4% period 1 83.1% 2 (p=0.005). significantly specifically posterior (35.8 vs 70.4%, p<0.001) anterior surface (based 0 mm clearance; 18.9 35.4%, p=0.045). Pathology period, poorly differentiated vascular invasion with R1 multivariable model. Extended DP, positive surface, lymph node ratio, perineural adjuvant chemotherapy but not significant prognostic factors overall survival cohort. Conclusion: a key determinant following A high be expected when meticulous standardized. Involvement affects prognosis.