Pancreatic neck margin testing shows limited benefit in cancer surgery.

• In a study of 403 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma, checking pancreatic neck margins with frozen section did not improve recurrence-free or overall survival outcomes.
• Median pancreatic neck recurrence-free survival was longer in patients with negative initial results (23.1 months) vs. those with revision clearance (16.9 months).

Surgical efforts to clear positive margins may lead to worse overall survival outcomes.

• Only 69% of positive frozen sections were resolved with revision, and pursuing completion total pancreatectomy for margin clearance carried risks of recurrence and mortality.