Appropriate Lymph Node Dissection Sites for Cancer in the Body and Tail of the Pancreas: A Multicenter Retrospective Study

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 retr...

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Bibliographic Details
Published in:Cancers 2022-09, Vol.14 (18), p.4409
Main Authors: Tanaka, Kimitaka, Kimura, Yasutoshi, Hayashi, Tsuyoshi, Ambo, Yoshiyasu, Yoshida, Makoto, Umemoto, Kazufumi, Murakami, Takeshi, Asano, Toshimichi, Nakamura, Toru, Hirano, Satoshi
Format: Article
Language:English
Subjects:
Blood transfusions
Cancer therapies
Care and treatment
Coronary vessels
Dissection
Hepatic artery
Hospitals
Lymph nodes
Lymphatic system
Medical prognosis
Metastases
Metastasis
Methods
Multivariate analysis
Pancreatectomy
Pancreatic cancer
Patients
Spleen
Splenic artery
Surgery
Survival
Tumors
Veins & arteries
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Summary: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.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14184409