Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005-2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis. The median overall survival (OS) of patients with metastatic PALN and with non-metastatic PALN (PALN-) was 14.1 and 20.2 months, respectively. Five of the PALN+ patients (36%) survived >19 months. The OS of PALN+ and those staged pN1 PALN- was not significantly different (P = 0.743). Patients who underwent surgical exploration or palliative surgery (n = 194) had a lower median survival of 8.8 (95% confidence interval: 7.3-10.1) months. PALN status could not be reliably predicted by preoperative computed tomography. We concluded that the survival data of PALN+ cases is comparable with advanced pN+ stages; one-third of the patients may expect longer survival after radical resection. Therefore, routine refusal of curative resection in the case of PALN metastasis is not indicated.
Details
Original language | English |
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Article number | 7688 |
Journal | Scientific Reports |
Volume | 7 |
Issue number | 1 |
Publication status | Published - 9 Aug 2017 |
Peer-reviewed | Yes |
External IDs
Scopus | 85027148092 |
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researchoutputwizard | legacy.publication#79495 |
researchoutputwizard | legacy.publication#79532 |
PubMed | 28794500 |
PubMedCentral | PMC5550512 |
ORCID | /0000-0001-5061-9643/work/153109643 |
Keywords
Sustainable Development Goals
Keywords
- Aged, Clinical Decision-Making, Disease Management, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lymph Nodes/pathology, Lymphatic Metastasis, Male, Middle Aged, Morbidity, Neoplasm Staging, Pancreatectomy, Pancreatic Neoplasms/diagnosis, Tomography, X-Ray Computed