PDF(Pubmed)
Abstract：
UNASSIGNED: The appropriate extent of lymphadenectomy for pancreatic cancer of the body/tail has not been standardized worldwide. The present study evaluated the optimal extent of harvesting lymph nodes.
UNASSIGNED: Patients who underwent distal pancreatectomy for invasive ductal carcinoma of the pancreas between 2007 and 2018 were retrospectively reviewed. Patients were subclassified into three groups depending on the tumor location: pancreatic body (Pb), proximal pancreatic tail (Ptp), and distal pancreatic tail (Ptd). The pancreatic tail was further divided into even sections of Ptp and Ptd. Patterns of lymph node metastasis and the impact of lymph node metastasis on the prognosis were examined.
UNASSIGNED: A total of 120 patients were evaluated. Fifty-eight patients had a tumor in the Pb, 38 in the Ptp, and 24 in the Ptd. No patients with a Ptd tumor had metastasis beyond the peripancreatic and splenic hilar lymph nodes (LN-PSH). All patients with metastasis to the lymph nodes along the common hepatic artery (LN-CHA) or along the left lateral superior mesenteric artery (LN-SMA) also had metastasis to the LN-PSH. Recurrence after surgery occurred significantly earlier in this population. In a multivariate analysis, metastasis to the LN-CHA or LN-SMA (hazard ratio [HR] 3.3; P = .04) was an independent risk factor for overall survival. Furthermore, high levels of preoperative serum CA19-9 (HR 10.9; P = .013) were a predictive factor for metastasis to the LN-CHA or LN-SMA.
UNASSIGNED: Metastasis to the LN-CHA or LN-SMA was rare but a significant prognostic factor in patients with pancreatic body/tail cancer.
UNASSIGNED: Patients who underwent distal pancreatectomy for invasive ductal carcinoma of the pancreas between 2007 and 2018 were retrospectively reviewed. Patients were subclassified into three groups depending on the tumor location: pancreatic body (Pb), proximal pancreatic tail (Ptp), and distal pancreatic tail (Ptd). The pancreatic tail was further divided into even sections of Ptp and Ptd. Patterns of lymph node metastasis and the impact of lymph node metastasis on the prognosis were examined.
UNASSIGNED: A total of 120 patients were evaluated. Fifty-eight patients had a tumor in the Pb, 38 in the Ptp, and 24 in the Ptd. No patients with a Ptd tumor had metastasis beyond the peripancreatic and splenic hilar lymph nodes (LN-PSH). All patients with metastasis to the lymph nodes along the common hepatic artery (LN-CHA) or along the left lateral superior mesenteric artery (LN-SMA) also had metastasis to the LN-PSH. Recurrence after surgery occurred significantly earlier in this population. In a multivariate analysis, metastasis to the LN-CHA or LN-SMA (hazard ratio [HR] 3.3; P = .04) was an independent risk factor for overall survival. Furthermore, high levels of preoperative serum CA19-9 (HR 10.9; P = .013) were a predictive factor for metastasis to the LN-CHA or LN-SMA.
UNASSIGNED: Metastasis to the LN-CHA or LN-SMA was rare but a significant prognostic factor in patients with pancreatic body/tail cancer.
摘要：
■胰腺癌体/尾部淋巴结清扫术的适当范围尚未在全球范围内标准化。本研究评估了收集淋巴结的最佳程度。
■对2007年至2018年间因胰腺浸润性导管癌而接受胰腺远端切除术的患者进行回顾性分析。根据肿瘤位置将患者分为三组：胰体（Pb），近端胰尾（Ptp），和远端胰尾（Ptd）。胰尾进一步分为Ptp和Ptd的均匀切片。检查淋巴结转移模式以及淋巴结转移对预后的影响。
■共评估了120例患者。58名患者患有铅肿瘤，38在Ptp中，Ptd中的24。没有Ptd肿瘤的患者在胰周和脾门淋巴结（LN-PSH）以外有转移。所有沿肝总动脉（LN-CHA）或沿左外肠系膜上动脉（LN-SMA）转移至淋巴结的患者也转移至LN-PSH。在该人群中，手术后复发明显较早。在多变量分析中，LN-CHA或LN-SMA转移(风险比[HR]3.3;P=.04)是总生存期的独立危险因素.此外，术前血清CA19-9水平升高(HR10.9;P=0.013)是LN-CHA或LN-SMA转移的预测因素.
■LN-CHA或LN-SMA的转移很少见，但在胰腺体/尾癌患者中是重要的预后因素。
■对2007年至2018年间因胰腺浸润性导管癌而接受胰腺远端切除术的患者进行回顾性分析。根据肿瘤位置将患者分为三组：胰体（Pb），近端胰尾（Ptp），和远端胰尾（Ptd）。胰尾进一步分为Ptp和Ptd的均匀切片。检查淋巴结转移模式以及淋巴结转移对预后的影响。
■共评估了120例患者。58名患者患有铅肿瘤，38在Ptp中，Ptd中的24。没有Ptd肿瘤的患者在胰周和脾门淋巴结（LN-PSH）以外有转移。所有沿肝总动脉（LN-CHA）或沿左外肠系膜上动脉（LN-SMA）转移至淋巴结的患者也转移至LN-PSH。在该人群中，手术后复发明显较早。在多变量分析中，LN-CHA或LN-SMA转移(风险比[HR]3.3;P=.04)是总生存期的独立危险因素.此外，术前血清CA19-9水平升高(HR10.9;P=0.013)是LN-CHA或LN-SMA转移的预测因素.
■LN-CHA或LN-SMA的转移很少见，但在胰腺体/尾癌患者中是重要的预后因素。
