Related Experiment Video
Updated: Apr 23, 2026
DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
Published on: February 1, 2020
Resection margin clearance in pancreatic cancer after implementation of the Leeds Pathology Protocol (LEEPP):
Florian Gebauer1, Michael Tachezy, Yogesh K Vashist
1Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistrasse 52, 20246, Hamburg, Germany, fgebauer@uke.de.
Background And Objectives:
The aim of this study was to assess the overall survival (OS) after R0/R1 resections in patients with pancreatic ductal adenocarcinoma (PDAC) of the pancreatic head after implementation of a standardized histopathologic protocol (Leeds Pathology Protocol, LEEPP).
Methods:
One hundred and twenty-five patients underwent surgical resection because of PDAC of the pancreatic head. Patients were histopathologically examined according to a standardized protocol. Their oncologic outcome and clinicopathologic data were compared with those of a patient group before implementation of the LEEPP (n = 116).
Results:
The R1 rate increased significantly from 13 to 52 %. There was no significant difference in OS between R0 and R1 resections. The median OS in patients with a tumor clearance of less than 2 mm from the resection margin was 15.1 months (12.1-18.1 months) versus 22.2 months (7.8-36.7 months) (P = 0.046). Multivariate analysis revealed a margin clearance or 2 mm and more as an independent prognosticator for OS.
Conclusions:
With applying the LEEPP, there was still no significant correlation between the R-status and OS in patients with PDAC. However, since a margin clearance of 2 mm or more is a predictive factor for OS, the R1 definition might have to be adapted in PDAC.
