Prognostic value of positive para - aortic lymph node in curative resection for pancreatic adenocarcinoma
Main Article Content
Abstract
The study was conducted to assess lymph node (LN) metastasis, complications and overall survival between postive and negative para - aortic LN (LN 16). The research was conducted retrospectively with convenient sampling of 42 patients who underwent pancreaticoduodenectomy, standard lymphadenectomy and LN 16 biopsy at Viet Duc Hospital from April 2014 to November 2019. The results showed the number of resected LN was higher in the LN 16 positive, although the difference was not statistically significant (p > 0,05). There was a significant difference in the number of positive LN between the two groups (6.83 ± 2.48 versus 0,81 ± 0,98) (p = 0,003). The overall survival time of for LN 16 positive group was 16.7 ± 2.4 months, which was statistically significantly lower than the other group (p < 0,05). In conclusion, LN16 metastasis is a bad prognostic factor. Surgeons should determine LN16 metastasis by biopsy to decide the optimal treatment for patients with pancreatic head cancer.
Article Details
Keywords
Para - aortic lymph node, pancreatic cancer, overall survival, complications, lymphadenectomy
References
2. Yokoyama Y, Nimura Y, Nagino M. Advances in the treatment of pancreatic cancer: limitations of surgery and evaluation of new
therapeutic strategies.Surgery today. 2009;39 (6):466 - 475.
3. Pavlidis TE, Pavlidis ET, Sakantamis AK. Current opinion on lymphadenectomy in pancreatic cancer surgery. Hepatobiliary Pancreat Dis Int.2011;10 (1):21 - 25.
4. Paiella S, Sandini M, Gianotti L, Butturini G, Salvia R, Bassi C. The prognostic impact of para - aortic lymph node metastasis in pancreatic cancer: A systematic review and meta - analysis. European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.2016;42 (5):616 - 624.
5. Tol JA, Gouma DJ, Bassi C, et al. Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS). Surgery.2014;156 (3):591 - 600,
6. Kawarada Y, Isaji S. Modified standard (D1 + alpha) pancreaticoduodenectomy for pancreatic cancer. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract. 2000;4 (3):227 - 228.
7. Nimura Y, Nagino M, Takao S, et al. Standard versus extended lymphadenectomy in radical pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas: long - term results of a Japanese multicenter randomized controlled trial. Journal of hepato
- Biliary - pancreatic sciences. 2012;19 (3):230 - 241.
8. Kondo S. Japanese Pancreas Society Staging Systems for Pancreatic Cancer. In: Neoptolemos JP, Urrutia R, Abbruzzese JL, Büchler MW, eds. Pancreatic Cancer. New York, NY: Springer New York; 2010:1035 - 1050,
9. Hackert T, Niesen W, Hinz U, et al. Radical surgery of oligometastatic pancreatic cancer. European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2017;43 (2):358 - 363.
10, Kim JS, Hwang HK, Lee WJ, Kang CM. Unexpected Para - aortic Lymph Node Metastasis in Pancreatic Ductal Adenocarcinoma: a Contraindication to Resection? Journal of Gastrointestinal Surgery.2019.