{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:01:14Z","timestamp":1783015274778,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The association of resection margin status with recurrence and survival after pancreatectomy for pancreas ductal adenocarcinoma (PDAC) remains controversial. The aim of this study was to identify the effect of R1 resection on recurrence pattern and survival after distal pancreatectomy for left\u2010sided PDAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent distal pancreatectomy for PDAC at two high\u2010volume institutions between January 2010 and December 2017 were retrospectively reviewed. Perioperative characteristics, pathological outcomes, recurrence pattern, and survival data were collected to compare R0 resection and R1 resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 558 patients who underwent distal pancreatectomy for PDAC, 158 patients (28.3%) showed R1 resection margin. R1 patients were associated with large tumor size (3.3\u00a0cm vs. 3.7\u2009cm, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.006) and lower number of positive lymph nodes (1.3 vs. 2.0, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.001). Median overall survival (37.3\u00a0months vs. 20.1\u2009months, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and recurrence\u2010free survival (14.6\u00a0months vs. 6.9\u2009months, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) significantly differed between the R0 and R1 groups. Disease recurrence patterns were not statistically different between the two groups (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.182). Among the recurrence patterns, peritoneal carcinomatosis had the shortest recurrence\u2010free survival (5.6\u00a0months, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) and overall survival (13.6\u00a0months, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) compared with all other recurrence patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>R1 resection margin after distal pancreatectomy was associated with poor survival and early recurrence. There is no significant difference in recurrence pattern between R0 and R1. Among the recurrence patterns, peritoneal carcinomatosis showed the worst prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1272","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T07:36:44Z","timestamp":1668584204000},"page":"633-643","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of resection margin status on recurrence pattern and survival in distal pancreatectomy for left\u2010sided pancreatic ductal adenocarcinoma"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8922-4374","authenticated-orcid":false,"given":"Jaewoo","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Surgery, Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Ryol","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seo Young","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Statistics and Data Science Korea National Open University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of Medicine and Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5422-5481","authenticated-orcid":false,"given":"Ki Byung","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of Medicine and Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-038X","authenticated-orcid":false,"given":"Dae Wook","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of Medicine and Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Ho","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Cheol","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of Medicine and Asan Medical Center  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