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Langenbeck's Archives of Surgery

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01-11-2020 | Metastasis | Review Article

Role of lymphadenectomy in resectable pancreatic cancer

Authors: Suna Erdem, Martin Bolli, Sascha A. Müller, Markus von Flüe, Rebekah White, Mathias Worni

Published in: Langenbeck's Archives of Surgery | Issue 7/2020

Abstract

Background

Pancreatic cancer (PC) remains one of the most devastating malignant diseases, predicted to become the second leading cause of cancer-related death by 2030. Despite advances in surgical techniques and in systemic therapy, the 5-year relative survival remains a grim 9% for all stages combined. The extent of lymphadenectomy has been discussed intensively for decades, given that even in early stages of PC, lymph node (LN) metastasis can be detected in approximately 80%.

Purpose

The primary objective of this review was to provide an overview of the current literature evaluating the role of lymphadenectomy in resected PC. For this, we evaluated randomized controlled studies (RCTs) assessing the impact of extent of lymphadenectomy on OS and studies evaluating the prognostic impact of anatomical site of LN metastasis and the impact of the number of resected LNs on OS.

Conclusions

Lymphadenectomy plays an essential part in the multimodal treatment algorithm of PC and is an additional therapeutic tool to increase the chance for surgical radicality and to ensure correct staging for optimal oncological therapy. Based on the literature from the last decades, standard lymphadenectomy with resection of at least ≥ 15 LNs is associated with an acceptable postoperative complication risk and should be recommended to obtain local radicality and accurate staging of the disease. Although radical surgery including appropriate lymphadenectomy of regional LNs remains the only chance for long-term tumor control, future studies specifically assessing the impact of neoadjuvant therapy on extraregional LNs are warranted.

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Title: Role of lymphadenectomy in resectable pancreatic cancer
Authors: Suna Erdem
Martin Bolli
Sascha A. Müller
Markus von Flüe
Rebekah White
Mathias Worni
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Lymphadenectomy
Pancreatic Cancer
Pancreatic Cancer
Published in: Langenbeck's Archives of Surgery / Issue 7/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01980-2

At a glance: The STEP trials

Springer Medicine

Role of lymphadenectomy in resectable pancreatic cancer

Abstract

Background

Purpose

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purpose

Conclusions

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