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Landmark Series: Importance of Pancreatic Resection Margins

  • Pancreatic Tumors
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Abstract

An important goal of cancer surgery is to achieve negative surgical margins and remove all disease completely. For pancreatic neoplasms, microscopic margins may remain positive despite gross removal of the palpable mass, and surgeons must then consider extending resection, even to the point of completion pancreatectomy, an option that renders the patient with significant adverse effects related to exocrine and endocrine insufficiency. Counterintuitively, extending resection to ensure clear margins may not improve patient outcome. Furthermore, the goal of improving survival by extending the resection may not be achieved, as an initial positive margin may indicate more aggressive underlying tumor biology. There is a growing body of literature on this topic, and this landmark series review will examine the key publications that guide our management for resection of pancreatic ductal adenocarcinoma, intraductal papillary mucinous neoplasms, and pancreatic neuroendocrine tumors.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Winship Cancer Institute, Atlanta, GA, USA

    Mihir M. Shah MD & David A. Kooby MD

  2. Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA

    Jashodeep Datta MD & Nipun B. Merchant MD

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  1. Mihir M. Shah MD
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  2. Jashodeep Datta MD
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  3. Nipun B. Merchant MD
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  4. David A. Kooby MD
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Correspondence to Mihir M. Shah MD.

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Mihir M. Shah, Jashodeep Datta, Nipun B. Merchant, and David A. Kooby have no relevant financial or commercial interests to disclose.

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Shah, M.M., Datta, J., Merchant, N.B. et al. Landmark Series: Importance of Pancreatic Resection Margins. Ann Surg Oncol 29, 1542–1550 (2022). https://doi.org/10.1245/s10434-021-11168-7

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