Published in:
01-03-2021 | Pancreatoduodenostomy | ASO Author Reflections
ASO Author Reflections: Optimal Procedure of Surgical Resection for Pancreatic Body Cancer under Consideration of Significance of Peripancreatic Head Lymph Node Dissection
Authors:
Taisuke Imamura, MD, PhD, Yusuke Yamamoto, MD, PhD, Teiichi Sugiura, MD, PhD, Yukiyasu Okamura, MD, PhD, Takaaki Ito, MD, PhD, Ryo Ashida, MD, PhD, Katsuhisa Ohgi, MD, Katsuhiko Uesaka, MD, PhD
Published in:
Annals of Surgical Oncology
|
Issue 3/2021
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Excerpt
Pancreatic cancer is known to invade adjacent organs and the nerve plexus around major vessels, and it has a high incidence of lymph node metastasis. Therefore, radical extended resection, including extended lymphadenectomy and dissection of the nerve plexus around major vessels, was emphasized to enhance resectability and survival. However, several randomized controlled studies
1‐
3 have demonstrated that extended pancreatectomy does not have survival benefit. The National Comprehensive Cancer Network (NCCN) guidelines mention that the goals of surgery for adenocarcinoma of the pancreas include oncologic resection of the primary tumor and regional lymph nodes. However, a consensus regarding the optimal extent of lymph node dissection has not yet been achieved. Especially for pancreatic body (Pb) cancer, whether a pancreatoduodenectomy (PD) or distal pancreatectomy (DP) is the optimal procedure remains unclear from the viewpoint of appropriate lymph node dissection. …
