Should a standard lymphadenectomy during pancreatoduodenectomy exclude para-aortic lymph nodes for all cases of resectable pancreatic head cancer? A consensus statement by the Chinese Study Group for Pancreatic Cancer (CSPAC)

  • Authors:
    • Chen Liu
    • Rufu Chen
    • Yingtai Chen
    • Deliang Fu
    • Defei Hong
    • Jihui Hao
    • Dawei Liu
    • Jiangtao Li
    • Shengping Li
    • Yixiong Li
    • Gang Mai
    • Yiping Mou
    • Quanxing Ni
    • Li Peng
    • Honggang Qian
    • Renyi Qin
    • Bei Sun
    • Chenghao Shao
    • Yongwei Sun
    • Bole Tian
    • Jian Wang
    • Wei Wang
    • Weilin Wang
    • Gang Zhao
    • Xianjun Yu
  • View Affiliations

  • Published online on: August 21, 2015     https://doi.org/10.3892/ijo.2015.3128
  • Pages: 1512-1516
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Abstract

Understanding and formulating an appropriate strategy for the para-aortic lymph nodes (LN16) during curative surgery for pancreatic head cancer have been controversial for some time. This study intended to provide a recommendation for surgeons to perform an optimal curative surgery on pancreatic cancer patients with or without LN16 involvement. Based on an updated literature search and review, the members of the Chinese Study Group for Pancreatic Cancer (CSPAC) from high-volume centers reached a consensus on the issue of LN16 in pancreatic head cancer. Metastasis to LN16 is quite common in pancreatic head cancer cases. Depending on the location of the tumor, including the ventral and dorsal pancreas, there could be various lymph node drainage pathways whereby LN16 does not necessarily belong to the Group 3 lymph node stations for all cases of pancreatic head cancer. Although LN16 involvement generally indicates a poor prognosis, some cohorts of LN16-involved cases have benefited from a curative surgery, and there is still a lack of level I evidence to convince surgeons to abandon all resectable cases with LN16 positivity. Resection of LN16 combined with a standard lymphadenectomy during pancreatoduodenectomy is recommended by CSPAC, except in patients with both positive LN16 and criteria based on: i) the resectability status of primary tumor; ii) the extent of involved para-aortic lymph nodes; and iii) the serum tumor burden assessed preoperatively.
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October-2015
Volume 47 Issue 4

Print ISSN: 1019-6439
Online ISSN:1791-2423

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Spandidos Publications style
Liu C, Chen R, Chen Y, Fu D, Hong D, Hao J, Liu D, Li J, Li S, Li Y, Li Y, et al: Should a standard lymphadenectomy during pancreatoduodenectomy exclude para-aortic lymph nodes for all cases of resectable pancreatic head cancer? A consensus statement by the Chinese Study Group for Pancreatic Cancer (CSPAC). Int J Oncol 47: 1512-1516, 2015.
APA
Liu, C., Chen, R., Chen, Y., Fu, D., Hong, D., Hao, J. ... Yu, X. (2015). Should a standard lymphadenectomy during pancreatoduodenectomy exclude para-aortic lymph nodes for all cases of resectable pancreatic head cancer? A consensus statement by the Chinese Study Group for Pancreatic Cancer (CSPAC). International Journal of Oncology, 47, 1512-1516. https://doi.org/10.3892/ijo.2015.3128
MLA
Liu, C., Chen, R., Chen, Y., Fu, D., Hong, D., Hao, J., Liu, D., Li, J., Li, S., Li, Y., Mai, G., Mou, Y., Ni, Q., Peng, L., Qian, H., Qin, R., Sun, B., Shao, C., Sun, Y., Tian, B., Wang, J., Wang, W., Wang, W., Zhao, G., Yu, X."Should a standard lymphadenectomy during pancreatoduodenectomy exclude para-aortic lymph nodes for all cases of resectable pancreatic head cancer? A consensus statement by the Chinese Study Group for Pancreatic Cancer (CSPAC)". International Journal of Oncology 47.4 (2015): 1512-1516.
Chicago
Liu, C., Chen, R., Chen, Y., Fu, D., Hong, D., Hao, J., Liu, D., Li, J., Li, S., Li, Y., Mai, G., Mou, Y., Ni, Q., Peng, L., Qian, H., Qin, R., Sun, B., Shao, C., Sun, Y., Tian, B., Wang, J., Wang, W., Wang, W., Zhao, G., Yu, X."Should a standard lymphadenectomy during pancreatoduodenectomy exclude para-aortic lymph nodes for all cases of resectable pancreatic head cancer? A consensus statement by the Chinese Study Group for Pancreatic Cancer (CSPAC)". International Journal of Oncology 47, no. 4 (2015): 1512-1516. https://doi.org/10.3892/ijo.2015.3128