Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma

Table 2 Margin status and tumour origin

	Duodenum		Ampulla		Distal Bile Duct		Pancreas		All tumour origins
	NSP	SP	NSP	SP	NSP	SP	NSP	SP	NSP	SP	p-value
	9	5	58	12	27	18	35	11	129	46
R1, n (%)	1 (11%)	2 (40%)	19 (33%)	5 (42%)	15 (56%)	17 (94%)	25 (71%)	10 (91%)	60 (47%)	34 (74%)	0.002
R0, n (%)	2 (22%)	3 (60%)	7 (12%)	7 (58%)	3 (11%)	1 (6%)	1 (3%)	1 (9%)	13 (10%)	12 (26%)
Rx, n (%)	6 (67%)	0	32 (55%)	0	9 (33%)	0	9 (26%)	0	56 (43%)	0
Pancreas transection margin	0	1	2	0	3	2	9	1	14 (11%)	4 (9%)	0.784
DBD transection margin	0	0	0	0	1	1	1	0	2 (2%)	1 (2%)	1.000
SMA margin	0	0	0	0	2	8	0	2	2 (2%)	10 (22%)	<0.001
Posterior surface	0	2	8	4	7	10	7	4	22 (17%)	20 (44%)	0.001
SMV surface	0	1	0	0	3	10	10	8	13 (10%)	19 (41%)	<0.001
Anterior surface	0	1	1	2	4	1	3	2	8 (6%)	6 (13%)	0.202

Margin status in 175 re-evaluated pancreaticoduodenectomies. NSP, non-standardized protocol. SP, standardized protocol. DBD, distal bile duct. SMA, superior mesenteric artery. SMV, superior mesenteric vein. For percentages and significances, calculations were made R0 vs R1 and Rx. In separate tumour origins, differences in R1-fraction between the SP-group and the NSP-group were significant in distal bile duct origin, (p = 0.006). Some NSP-cases were classified as R1 in an unspecified margin. R1-cases could have more than one involved margin. Bold text indicates p < 0.05.

ISSN: 1746-1596