Can the surgeon prolong the remaining life of the patient in pancreaticoduodenectomy surgery? or Is the surgeon helpless?

Abstract

Background: We aimed to evaluate the effects of R0 and R1 resections after pancreatic surgery. Methods: Data of 130 patients were evaluated. Re-resection was performed in patients who were found to have R1 resection after frozen section (FS). Overall survival (OS), disease free survival (DFS) among patients with R1 resection in paraffin section (PS) (n:28, Group1) and patients who underwent re-resection after FS and achieved the R0 resection goal in PS (n:16, Group 2) (DFS), local recurrence and systemic metastasis results were compared. Results: Tumor diameter, differentiation, age and complications were found to negatively affect OS. It was observed that DFS increased (p:0.02) and local recurrence rates decreased (p:0.037) in group 2 compared but there was no difference between the two groups in terms of OS (p:0.420) and systemic metastasis (p:0.467). Conclusions: R0 resection obtained by surgical margin resection of the neck in pancreatic head adenocarcinomas decreases local recurrence and increases the duration of DFS. However, it has no effect on preventing OS and systemic metastasis.

Keywords

• Pancreas cancer. Surgical margins. Re-resection. Overall survival. Recurrens.