Prognostic Significance of Lymph Node Metastasis and Micrometastasis Along the Left Side of Superior Mesenteric Artery in Pancreatic Head Cancer

Backgrounds and Objectives Although metastasis in lymph nodes along the left side of superior mesenteric artery (SMA-LNs-lt) is sometimes found, survival benefit of SMA-LN-lt dissection for pancreatic head cancer is still unclear. The purpose of this study is to evaluate the prognostic significance...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2019-10, Vol.23 (10), p.2100-2109
Main Authors: Okada, Kenjiro, Murakami, Yoshiaki, Kondo, Naru, Uemura, Kenichiro, Nakagawa, Naoya, Seo, Shingo, Takahashi, Shinya, Sueda, Taijiro
Format: Article
Language:English
Subjects:
2018 SSAT Quick Shot Presentation
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - therapeutic use
Chemotherapy
Chemotherapy, Adjuvant
Female
Gastroenterology
Head & neck cancer
Humans
Lymph Node Excision
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Medical prognosis
Medicine
Medicine & Public Health
Mesenteric Artery, Superior
Metastasis
Middle Aged
Neoplasm Micrometastasis
Pancreatectomy
Pancreatic Neoplasms - drug therapy
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Prognosis
Retrospective Studies
Surgery
Survival Rate
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Summary:Backgrounds and Objectives Although metastasis in lymph nodes along the left side of superior mesenteric artery (SMA-LNs-lt) is sometimes found, survival benefit of SMA-LN-lt dissection for pancreatic head cancer is still unclear. The purpose of this study is to evaluate the prognostic significance of SMA-LN-lt metastasis and micrometastasis. Methods A total of 166 patients with pancreatic head cancer who underwent pancreatectomy with lymphadenectomy including SMA-LNs-lt between 2002 and 2017 were reviewed retrospectively. Micrometastasis was evaluated by immunohistochemistry. Results Twenty patients (12%) had SMA-LN-lt metastasis detected by hematoxylin and eosin (HE) staining, and eight patients (5%) had micrometastasis. Patients with SMA-LN-lt HE-positive or micrometastasis group experienced significantly shorter overall survival (OS) than those without ( p  = .015). In multivariate analysis, SMA-LN-lt HE-positive or micrometastasis ( p  = .034), portal vein resection ( p  = .002), histologic grade 2/3 ( p  = .046), LN metastasis ( p  = .002), and lack of adjuvant chemotherapy ( p  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-019-04359-x