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Lookup NU author(s): Sanjay PandanaboyanaORCiD
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© 2017 International Hepato-Pancreato-Biliary Association Inc.Background Margin status is the main surgical determinant of long-term outcome in pancreatic cancer. Intraoperative frozen section (IOFS) detects microscopic positive margins at a stage when margin revision is possible. The aim of this study was to determine if IOFS driven-revision of pancreatic resection margin(s) improves overall survival (OS) in pancreatic cancer. Methods A systematic review of major reference databases was undertaken. Patients were divided into 3 groups based on initial FS (FSR0 for negative margin and FSR1 for positive microscopic margin) and final Permanent Section report (PSR0 for negative margin and PSR1 for positive microscopic margin): Group 1 (FSR0 → PSR0), Group 2 (FSR1 → PSR0), and Group 3 (FSR1 → PSR1). Patients in Groups 2 and 3 had surgical revision of the FSR1 margin. Data was meta-analysed. Results 4 studies included in the final analysis. No difference in OS and incidence of lymph node metastases between Groups 2 and 3 (P = 0.590 and P = 0.410). Conclusions IOFS-based revision of R1 pancreatic resection margin does not improve OS, even when it results in an R0 margin. This suggests that any benefit of margin revision based on FS is over-ridden by markers of more advanced or aggressive disease.
Author(s): Barreto SG, Pandanaboyana S, Ironside N, Windsor JA
Publication type: Review
Publication status: Published
Journal: HPB
Year: 2017
Volume: 19
Issue: 7
Pages: 573-579
Online publication date: 15/04/2017
Acceptance date: 01/03/2017
ISSN (print): 1365-182X
ISSN (electronic): 1477-2574
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.hpb.2017.03.006
DOI: 10.1016/j.hpb.2017.03.006
PubMed id: 28420560
