Para‐aortic lymph node sampling in pancreatic head adenocarcinoma

摘要: Background The significance of positive para-aortic nodes in patients with resectable pancreatic carcinoma is unclear. This study sought to evaluate the accuracy intraoperative detection and prognostic these lymph resected adenocarcinoma head. Methods From 2000 2010, node sampling was performed prospectively all before pancreatoduodenectomy. Frozen sections were created categorized as or negative for metastases. Surgeons blinded frozen-section results. followed by standard histopathological assessment corresponding paraffin-embedded, haematoxylin eosin-stained material. Nodes considered uninvolved this analysis examined immunohistochemically micrometastases. Results A total 111 consecutive included, a median follow-up 20·8 (range 1·5–126) months. The 1-, 2- 5-year overall survival (OS) disease-free (DFS) rates 73·6, 54·0 24·7 per cent, 51·8, 28·1 18·8 cent respectively. Para-aortic involvement always associated peripancreatic metastasis, detected 12 eosin staining 17. Sensitivity specificity examination detecting metastases 71 100 Median OS without on 9·7 versus 28·5 months respectively (P = 0·012), 15·7 27·2 months (P = 0·050) when assessed staining. DFS 5·6 12·9 months (P = 0·041), 8·4 (P = 0·038) analysis. presence micrometastases not significantly altered DFS. Conclusion Para-aortic detects distant lymphatic reliably. It should be systematically. When are found, they contraindication resection.