OBJECTIVES: The purpose of this study was to determine the operative indications for pancreatic cancer with paraaortic lymph node metastases (No. 16 [+]). METHODS: Between July 1981 and March 2007, 335 patients with pancreatic cancer including 45 No. 16 (+) patients underwent extended radical surgery at the Department of Surgery II, Nagoya University. The overall survival rates and clinicopathological parameters were analyzed using univariate and multivariate analyses. RESULTS: Although there was no significant difference in survival between the No. 16 (+) patients and the unresectable cases, there were some long-term survivors among the No. 16 (+) patients. Multivariate analysis of the No. 16 (+) patients identified age (59 years or younger), tumor size (>4 cm), and pathologically confirmed portal invasion (pPV[+]) as independent prognostic factors. The survival of No. 16 (+) patients without these factors was significantly better than the unresectable cases. The survival of patients with only 1 metastatic paraaortic lymph node also was significantly better than the unresectable cases, and tended to be better than those with more than 2 metastatic nodes. CONCLUSIONS: No. 16 (+) pancreatic cancer patients with age 60 years or older, tumor size 4 cm or less, and pPV(-) may benefit from resection.
OBJECTIVES: The purpose of this study was to determine the operative indications for pancreatic cancer with paraaortic lymph node metastases (No. 16 [+]). METHODS: Between July 1981 and March 2007, 335 patients with pancreatic cancer including 45 No. 16 (+) patients underwent extended radical surgery at the Department of Surgery II, Nagoya University. The overall survival rates and clinicopathological parameters were analyzed using univariate and multivariate analyses. RESULTS: Although there was no significant difference in survival between the No. 16 (+) patients and the unresectable cases, there were some long-term survivors among the No. 16 (+) patients. Multivariate analysis of the No. 16 (+) patients identified age (59 years or younger), tumor size (>4 cm), and pathologically confirmed portal invasion (pPV[+]) as independent prognostic factors. The survival of No. 16 (+) patients without these factors was significantly better than the unresectable cases. The survival of patients with only 1 metastatic paraaortic lymph node also was significantly better than the unresectable cases, and tended to be better than those with more than 2 metastatic nodes. CONCLUSIONS: No. 16 (+) pancreatic cancerpatients with age 60 years or older, tumor size 4 cm or less, and pPV(-) may benefit from resection.
Authors: Thomas Seufferlein; Marc Porzner; Volker Heinemann; Andrea Tannapfel; Martin Stuschke; Waldemar Uhl Journal: Dtsch Arztebl Int Date: 2014-05-30 Impact factor: 5.594
Authors: Lennart B van Rijssen; Poorvi Narwade; Nadine C M van Huijgevoort; Dorine S J Tseng; Hjalmar C van Santvoort; Isaac Q Molenaar; Hanneke W M van Laarhoven; Casper H J van Eijck; Olivier R C Busch; Marc G H Besselink Journal: HPB (Oxford) Date: 2016-05-27 Impact factor: 3.647