Analysis of paraaortic lymph node involvement in pancreatic carcinoma: a significant indication for surgery?

摘要: BACKGROUND Lymph node status is a key prognostic factor for pancreatic carcinoma. The paraaortic lymph nodes are the highest level of that can be resected safely in abdomen and other gastrointestinal tumors. pattern involvement its relation with groups were analyzed significance this information relative to surgical therapy examined. METHODS Between 1974–1996, 99 patients invasive ductal carcinoma pancreas underwent pancreatectomy at study institution. involvement, particularly paraaortic, was evaluated by careful pathologic review extended lymphadenectomy specimens. RESULTS Fifty-eight 76 (76%) head (Ph) 19 23 (83%) body tail (Pbt) had involvement. Fourteen Ph disease (18%) 4 Pbt (17%) Tumor size did not correlate A correlation found between Group 13 (posterior pancreaticoduodenal nodes), 14 (lymph surrounding superior mesenteric artery), disease. All metastases located 16M region (the celiac trunk inferior artery). For disease, distribution same as those Only 33% cases suspected preoperatively or perioperatively. longest survival patient 36 months 17 months, respectively, disease. CONCLUSIONS The frequent sites metastasis from carcinoma, difficult evaluate This situation mandates dissection, least region. Cancer 1999;85:583–90. © 1999 American Society.