Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma.

Autor: Sillesen M; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark. Martin.Sillesen@Regionh.dk.; Center for Surgical Translation and Artificial Intelligence Research (CSTAR), Copenhagen University Hospital, Rigshospitalet, Denmark. Martin.Sillesen@Regionh.dk.; Institute of Clinical Medicine, University of Copenhagen, København, Denmark. Martin.Sillesen@Regionh.dk., Hansen CP; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark., Burgdorf SK; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark., Dencker EE; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark.; Center for Surgical Translation and Artificial Intelligence Research (CSTAR), Copenhagen University Hospital, Rigshospitalet, Denmark., Krohn PS; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark., Gisela Kollbeck SL; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark.; Center for Surgical Translation and Artificial Intelligence Research (CSTAR), Copenhagen University Hospital, Rigshospitalet, Denmark., Stender MT; Department of Surgery, Aalborg University Hospital, Aalborg, Denmark., Storkholm JH; Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen, 2100, Denmark.; Dep. of Surgery, Imperial College NHS trust, Hammersmith Hospital, London, UK.
Jazyk: angličtina
Zdroj: BMC surgery [BMC Surg] 2023 Aug 01; Vol. 23 (1), pp. 214. Date of Electronic Publication: 2023 Aug 01.
DOI: 10.1186/s12893-023-02123-2
Abstrakt: Introduction: For PDAC patients undergoing resection, it remains unclear whether metastases to the paraaortic lymph nodes (PALN+) have any prognostic significance and whether metastases should lead to the operation not being carried out. Our hypothesis is that PALN + status would be associated with short overall survival (OS) compared with PALN-, but longer OS compared with patients undergoing surgical exploration only (EXP).
Methods: Patients with registered PALN removal from the nationwide Danish Pancreatic Cancer Database (DPCD) from May 1st 2011 to December 31st 2020 were assessed. A cohort of PDAC patients who only had explorative laparotomy due to non-resectable tumors were also included (EXP group). Survival analysis between groups were performed with cox-regression in a multivariate approach including relevant confounders.
Results: A total of 1758 patients were assessed, including 424 (24.1%) patients who only underwent explorative surgery leaving 1334 (75.8%) patients for further assessment. Of these 158 patients (11.8%) had selective PALN removal, of whom 19 patients (12.0%) had PALN+. Survival analyses indicated that explorative surgery was associated with significantly shorter OS compared with resection and PALN + status (Hazard Ratio 2.36, p < 0.001). No difference between PALN + and PALN- status could be demonstrated in resected patients after controlling for confounders.
Conclusion: PALN + status in patients undergoing resection offer improved survival compared with EXP. PALN + should not be seen as a contraindication for curative intended resection.
(© 2023. The Author(s).)
Databáze: MEDLINE
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