Incidence and prognostic impact of para-aortic lymph nodes metastases during pancreaticoduodenectomy for peri-ampullary cancer

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Gennaro NappoRoberto Coppola

Abstract

Standard lymphadenectomy during pancreaticoduodenectomy (PD) for peri-ampullary cancer does not include the routine removal of para-aortic lymph nodes (PALN) (station 16, according to the JPS staging system). The aim of this study was to report the incidence and the prognostic value of PALN metastases in patients undergoing PD for peri-ampullary cancer. One hundred thirty-five consecutive patients who underwent PD and PALN dissection for peri-ampullary cancer were prospectively evaluated. The relationship between clinicopathological factors, including PALN metastases and survival was evaluated at univariate and multivariate analysis. PALN metastases (N16+) were found in 11.1% of cases. At univariate analysis, R1 resection, metastatic nodes different from para aortic (N1) and N16+ significantly affected patients' prognosis. Compared with N16+, the median overall survival (OS) of N0 patients was significantly longer (32 versus 69 months, respectively; P < 0.05), whereas no difference was found between N16+ and N1 patients (32 versus 34 months, respectively) (P > 0.05). At multivariate analysis, only R1 resection reached statistical significance and was confirmed an independent prognostic factor. Neoplastic involvement of PALN in ...Continue Reading

References

Jun 12, 2004·American Journal of Surgery·Takanori YoshidaSeigo Kitano
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Citations

Jun 28, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Lennart B van RijssenUNKNOWN Dutch Pancreatic Cancer Group
Jan 23, 2020·World Journal of Surgical Oncology·Sebastian HempelThilo Welsch
Jul 15, 2017·World Journal of Gastroenterology : WJG·Cosimo SpertiLucia Moletta

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