Highlights
- •Positive margins signify poor tumor biology.
- •Tumors over 4 cm in the tail are associated with positive margins.
- •Tumors in the body are associated with positive margins regardless of size.
Abstract
Background
Radical resection (RAMPS) of left sided pancreatic ductal adenocarcinoma (PDAC) is
effective in achieving R0 margins; however, not universally accepted due to lack of
improved survival. We hypothesized that only larger tumors lead to R1 in non-RAMPS
procedures.
Methods
A retrospective review of charts between 2008 and 2020 was performed. The primary
outcome was evaluating R0 resection based on left-sided tumors’ size and location,
and secondary outcomes were OS and DFS.
Results
Sixty-eight percent had R0 resection. R1 groups’ tumors were larger (5.5 cm vs. 3.8 cm,
p = 0.004) and had higher LVI involvement (p = 0.003). OS and DFS did not differ on
multivariate analysis. Tumor size above 4 cm in the tail was associated with R1 (p = 0.01).
Conclusions
Larger tumors in the tail, but not body were associated with R1, but not worse survival.
Perhaps larger tumors in the tail are a surrogate marker of poor disease biology.
Keywords
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Article info
Publication history
Published online: May 23, 2022
Accepted:
May 20,
2022
Received in revised form:
April 16,
2022
Received:
November 14,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
