Practical grouping of positive lymph nodes in pancreatic head cancer treated by an extended pancreatectomy

摘要: Background. Until recently long-term survival has not been expected when at least one positive node was detected any site in pancreatic head cancer treated by conventional pancreatectomy. However, even nodal involvement is seen, there an increasing number of survivors after extended pancreatectomy which a wide range lymphatic and connective tissues were cleared.1 Thus the purpose present study to establish practical rational grouping lymph nodes pancreatectomy. Methods. In 81 patients who tolerated for head, mean 56 ± 23 (range, 28 89) each patient examined under microscope determine presence or absence cancer. They classified anatomically into 14 groups, incidence, distribution, examined. A simplified made on basis histologic findings checked against rates. Results. Nodal 59 (73%) patients, more commonly observed posterior pancreaticoduodenal (PPD), superior mesenteric (SM), anterior (APD) groups than 11 other (p < 0.05). The PPD, APD, SM offered sole sites with incidence levels 23%, 17%, 6%, respectively, whereas none did. four groups: (a), negative all (n = 22); (b), but limited PPD/APD 14); (c), also group, 13); (d), 32). This classification associated well 5-year rate: 59% group 53% 15% 0% (d) [p 0.05; (b) versus (c)]. Also this total rate three 47% 6% seven 0.05). Conclusions. clinicopathologic staging spread from carcinoma PPD APD considered first stations metastasis, 12 groups—including group—were categorized as second distant stations.