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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 9/2018

01-09-2018 | Original Article

Revision of Surgical Margin under Frozen Section to Achieve R0 Status on Survival in Patients with Pancreatic Cancer

Authors: Zi Yin, Yu Zhou, Baohua Hou, Tingting Ma, Min Yu, Chuanzhao Zhang, Xin Lu, Zhixiang Jian

Published in: Journal of Gastrointestinal Surgery | Issue 9/2018

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Abstract

Objective

The aim is to investigate whether additional resection based on intraoperative frozen section (FS) to a secondary R0(s) status are associated with different long-term survivals in pancreatic cancer patients, comparing to those with R1 or primary R0(p) status.

Methods

A systematic literature search (PubMed, Embase, Science Citation Index, Springer-Link, and Cochrane Central Register of Controlled Trials) was performed to identify all studies published up to June 2017. Survivals of patients undergoing pancreatic surgery according to the results of FS and re-resection were pooled for analysis.

Results

Five cohort studies were qualified for inclusion in this review with a total of 2980 patients. Long-term survival outcomes favored R0(p) resection as compared to R0(s) resection (HR = 1.58, 95%CI 1.24–2.01, P = 0.0002, I2 = 58%). No significant difference was observed for patients with or without additional resection at the time of surgery when positive FS was detected (HR = 0.98, 95CI% 0.65–1.47, P = 0.91, I2 = 81%).

Conclusions

The present study did not support the concept of achieving an R0 resection by intraoperative re-resection would benefit the patient’s survival. R1 margin at the time of surgery is more like a marker of aggressive tumor biology. Future well-designed randomized controlled trials are needed to confirm the conclusion.
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Metadata
Title
Revision of Surgical Margin under Frozen Section to Achieve R0 Status on Survival in Patients with Pancreatic Cancer
Authors
Zi Yin
Yu Zhou
Baohua Hou
Tingting Ma
Min Yu
Chuanzhao Zhang
Xin Lu
Zhixiang Jian
Publication date
01-09-2018
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 9/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3806-x

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