Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection

Abstract No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatod...

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Autores principales:	Sebastian Hempel, Verena Plodeck, Franz Mierke, Marius Distler, Daniela E. Aust, Hans-Detlev Saeger, Jürgen Weitz, Thilo Welsch
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d10062847a524af3a9ee1988da84a66d
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spelling	oai:doaj.org-article:d10062847a524af3a9ee1988da84a66d2021-12-02T12:30:53ZPara-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection10.1038/s41598-017-08165-w2045-2322https://doaj.org/article/d10062847a524af3a9ee1988da84a66d2017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-08165-whttps://doaj.org/toc/2045-2322Abstract No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005–2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis. The median overall survival (OS) of patients with metastatic PALN and with non-metastatic PALN (PALN−) was 14.1 and 20.2 months, respectively. Five of the PALN+ patients (36%) survived >19 months. The OS of PALN+ and those staged pN1 PALN− was not significantly different (P = 0.743). Patients who underwent surgical exploration or palliative surgery (n = 194) had a lower median survival of 8.8 (95% confidence interval: 7.3–10.1) months. PALN status could not be reliably predicted by preoperative computed tomography. We concluded that the survival data of PALN+ cases is comparable with advanced pN+ stages; one-third of the patients may expect longer survival after radical resection. Therefore, routine refusal of curative resection in the case of PALN metastasis is not indicated.Sebastian HempelVerena PlodeckFranz MierkeMarius DistlerDaniela E. AustHans-Detlev SaegerJürgen WeitzThilo WelschNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-7 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sebastian Hempel Verena Plodeck Franz Mierke Marius Distler Daniela E. Aust Hans-Detlev Saeger Jürgen Weitz Thilo Welsch Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
description	Abstract No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005–2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis. The median overall survival (OS) of patients with metastatic PALN and with non-metastatic PALN (PALN−) was 14.1 and 20.2 months, respectively. Five of the PALN+ patients (36%) survived >19 months. The OS of PALN+ and those staged pN1 PALN− was not significantly different (P = 0.743). Patients who underwent surgical exploration or palliative surgery (n = 194) had a lower median survival of 8.8 (95% confidence interval: 7.3–10.1) months. PALN status could not be reliably predicted by preoperative computed tomography. We concluded that the survival data of PALN+ cases is comparable with advanced pN+ stages; one-third of the patients may expect longer survival after radical resection. Therefore, routine refusal of curative resection in the case of PALN metastasis is not indicated.
format	article
author	Sebastian Hempel Verena Plodeck Franz Mierke Marius Distler Daniela E. Aust Hans-Detlev Saeger Jürgen Weitz Thilo Welsch
author_facet	Sebastian Hempel Verena Plodeck Franz Mierke Marius Distler Daniela E. Aust Hans-Detlev Saeger Jürgen Weitz Thilo Welsch
author_sort	Sebastian Hempel
title	Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
title_short	Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
title_full	Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
title_fullStr	Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
title_full_unstemmed	Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
title_sort	para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/d10062847a524af3a9ee1988da84a66d
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Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection

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