Preoperative assessment of para-aortic lymph node metastasis in patients with pancreatic cancer

Autor: Ryuichiro Doi, Naoko Kamo, Toshihiko Masui, Yoshiya Kawaguchi, Masayuki Koizumi, Hisashi Imai, Hiroyoshi Isoda, Shinji Uemoto, Yasuhiro Iwanaga, Hiroyuki Kanazawa, Yasutsugu Takada
Rok vydání: 2009
Předmět:
Adult
Male
medicine.medical_specialty
Metastasis
Pancreatectomy
Japan
Surgical oncology
Fluorodeoxyglucose F18
Predictive Value of Tests
Pancreatic cancer
Preoperative Care
Medicine
Humans
Neoplasm Invasiveness
Lymph node
Aged
Neoplasm Staging
Aged
80 and over
Frozen section procedure
Chi-Square Distribution
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Hematology
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Pancreatic Neoplasms
Dissection
medicine.anatomical_structure
Para-aortic lymph node metastasis
Oncology
Lymphatic Metastasis
Positron-Emission Tomography
Invasive ductal carcinoma of the pancreas
Diagnostic imaging
Lymph Node Excision
Surgery
Female
Radiology
Lymph Nodes
Radiopharmaceuticals
business
Pancreas
Tomography
X-Ray Computed
Carcinoma
Pancreatic Ductal
Zdroj: International journal of clinical oncology. 15(3)
ISSN: 1437-7772
Popis: BACKGROUND: Para-aortic lymph node (PALN) metastasis is an important prognostic factor in patients with pancreatic cancer, but accurate preoperative diagnosis is difficult. The objective of this study was to assess the accuracy of diagnosis of PALN by computed tomography (CT), magnetic resonance imaging (MRI), and (18)F-fluorodeoxyglucose positron-emission tomography (FDG-PET). METHODS: From August 2005 to July 2008, 119 patients with invasive ductal adenocarcinoma of the pancreas were included in this study. PALNs with a longer diameter >10 mm on CT or MRI were suspected of being involved by metastasis, whereas FDG uptake exceeding that of the adjacent normal tissue was considered to be positive for metastasis on FDG-PET studies. The imaging findings were compared with the pathological diagnosis of PALN metastasis. RESULTS: PALN dissection was performed in 71 patients (60.0%). Although histopathological examination revealed metastasis in 6 patients (8.5%), none of these patients was positive in any of the preoperative imaging studies. The longer diameter, the shorter diameter, the ratio of the two diameters, and the calculated lymph node volume showed no significant differences between patients with and without PALN metastasis. CONCLUSIONS: Preoperative detection of PALN metastasis in patients with pancreatic cancer is very difficult. Intraoperative histopathological examination of frozen sections is necessary if radical resection is contemplated.
Databáze: OpenAIRE
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