Optimal lymph-node dissection for pancreatic tail cancer

Surg Today. 2022 Sep;52(9):1307-1312. doi: 10.1007/s00595-022-02463-1. Epub 2022 Feb 18.

Abstract

Purpose: The optimal range of lymph-node dissection for pancreatic tail cancer remains unclear. We investigated the location and frequency of lymph-node metastases to identify the correct range of lymph-node dissection for pancreatic tail cancer.

Methods: We analyzed clinical data retrospectively, on patients who underwent distal pancreatectomy for resectable left-sided pancreatic cancer, between February, 2006 and March, 2021. Eligible patients were divided into two groups according to the tumor location: those with pancreatic tail cancer (Pt group) and those with pancreatic body or body and tail cancer (non-Pt group).

Results: Of the 96 patients analyzed, 61 (64%) were assigned to the Pt group and 35 (36%) were assigned to the non-Pt group. Metastases to stations 7, 8, 9, 10, 11, 14, and 18 were found in 0 (0%), 0 (0%), 0 (0%), 4 (7%), 18 (30%), 2 (4%), and 10 (17%) patients in the Pt group, and in 1 (3%), 4 (12%), 2 (6%), 1 (3%), 18 (51%), 3 (9%), and 6 (17%) patients in the non-Pt group, respectively.

Conclusion: Lymph-node dissection at stations 7, 8, and 9 might not be necessary in patients with resectable pancreatic cancer confined to the pancreatic tail.

Keywords: Distal pancreatectomy; Pancreatic ductal carcinoma; Tumor metastasis.

MeSH terms

  • Humans
  • Lymph Node Excision
  • Pancreatectomy
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery
  • Retrospective Studies