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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
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Appropriate Lymph Node Dissection Sites for Cancer in the Body and Tail of the Pancreas : A Multicenter Retrospective Study
| Title: | Appropriate Lymph Node Dissection Sites for Cancer in the Body and Tail of the Pancreas : A Multicenter Retrospective Study |
| Authors: | Tanaka, Kimitaka Browse this author →KAKEN DB | | Kimura, Yasutoshi Browse this author | | Hayashi, Tsuyoshi Browse this author | | Ambo, Yoshiyasu Browse this author | | Yoshida, Makoto Browse this author | | Umemoto, Kazufumi Browse this author | | Murakami, Takeshi Browse this author | | Asano, Toshimichi Browse this author | | Nakamura, Toru Browse this author | | Hirano, Satoshi Browse this author →KAKEN DB |
| Keywords: | pancreatic cancer | | distal pancreatectomy | | lymph node metastasis | | spleen preservation | | efficacy index |
| Issue Date: | Sep-2022 |
| Publisher: | MDPI |
| Journal Title: | Cancers |
| Volume: | 14 |
| Issue: | 18 |
| Start Page: | 4409 |
| Publisher DOI: | 10.3390/cancers14184409 |
| Abstract: | Simple Summary Distal pancreatectomy has become the standard surgery for patients with pancreatic body-tail cancers. The optimal area for dissection remains controversial, and there is an emphasis on preserving as much tissue as possible while eradicating the cancer. This multicenter, retrospective study evaluated the frequency and patterns of lymph node metastasis based on tumor site among 235 patients with pancreatic body-tail cancers to determine the optimal lymph node dissection area for distal pancreatectomy. Patients with pancreatic body cancer tumors showed no metastasis to the splenic hilum lymph node. Spleen-preserving pancreatectomy might be feasible for Pb cancer. Distal pancreatectomy (DP) with lymphadenectomy is the standard surgery for pancreatic body-tail cancer. However, the optimal lymph node (LN) dissection area for DP remains controversial. Thus, we evaluated the frequency and patterns of LN metastasis based on the tumor site. In this multicenter retrospective study, we examined 235 patients who underwent DP for pancreatic cancer. Tumor sites were classified as confined to the pancreatic body (Pb) or pancreatic tail (Pt). The efficacy index (EI) was calculated by multiplying the frequency of metastasis to each LN station by the five-year survival rate of patients with metastasis to that station. LN metastasis occurred in 132/235 (56.2%) of the patients. Patients with Pb tumors showed no metastasis to the splenic hilum LN. Distal splenic artery LNs and anterosuperior/posterior common hepatic artery LNs did not benefit from dissection for Pb and Pt tumors, respectively. In multivariate analysis, splenic artery LN metastasis was identified as an independent predictor of poor overall survival in patients with pancreatic body-tail cancer. In conclusion, differences in metastatic LN sites were evident in pancreatic body-tail cancers confined to the Pb or Pt. Spleen-preserving pancreatectomy might be feasible for Pb cancer. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/87347 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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