Background/Purpose: The outcomes of patients with intraepithelial neoplasia at the pancreatic transection margin after pancreatic cancer surgery remain unclear. We evaluated the clinical impact of pancreatic transection margin status.
Methods: This retrospective observational study included 171 patients who underwent surgery for pancreatic ductal adenocarcinoma between January, 2008 and December, 2019. Patients were classified into three groups: negative pancreatic transection margin (group N), positive low-grade (group L), and positive high-grade (group H) intraepithelial neoplasia. The clinicopathological findings and prognoses were analyzed for each group.
Results: There were 140, 14, and 9 patients in groups N, L, and H, respectively. The median age was significantly higher in group H (p = 0.035). There were no significant differences in male ratio, preoperative chemotherapy administration rate, pretreatment tumor markers, operative procedure, operative time, or blood loss. Overall survival and recurrence-free survival were not significantly different; however, the cumulative risk of recurrence in the remnant pancreas was significantly higher in group H (p = 0.016)?Figure1?. The location of residual pancreatic recurrence was away from the transection margin in any of the cases.
Conclusions: Intraepithelial neoplasia at the pancreatic transection margin did not affect overall/ recurrence-free survival. In high-grade intraepithelial neoplasia positive patients, follow-up of residual pancreatic recurrence is important, but it should be noted that recurrence does not necessarily occur at the dissected pancreatic margins.
Figure 1.
