Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1988 Aug;208(2):215–220. doi: 10.1097/00000658-198808000-00014

Practical usefulness of lymphatic and connective tissue clearance for the carcinoma of the pancreas head.

O Ishikawa 1, H Ohhigashi 1, Y Sasaki 1, T Kabuto 1, I Fukuda 1, H Furukawa 1, S Imaoka 1, T Iwanaga 1
PMCID: PMC1493620  PMID: 2840866

Abstract

We performed a retrospective review of 59 pancreatic resections for ductal carcinoma of the pancreas head performed between 1971 and 1983. In addition to pancreaticoduodenectomy, 37 consecutive patients (from 1971 to 1981) received lymphatic dissection adjacent to the pancreatic head (Group R1), whereas another 22 patients (from 1981 to 1983) received a wider range of lymphatic and soft tissue dissection, including the para-aortic region (Group R2). These groups did not differ with regard to operative mortality rate or background factors in the patients who tolerated operation. The 3-year cumulative survival rate was 13% in the R1 group vs. 38% in the R2 group (p less than 0.05). Almost all of the deaths from cancer recurrence occurred within 3 years after operation; the cumulative rate of death from local recurrence decreased from 67 to 16% (p less than 0.05) at 3 years. Among the patients with nodal involvement, there was no 3-year survivor in the R1 group, but four (27%) in the R2 group (p less than 0.05) survived. Among the patients whose tumor size exceeded 4 cm with retroperitoneal invasion, there was no 3-year survivor in either group and most patients died of distant metastasis. Extended clearance of regional lymph nodes and soft tissue appears to benefit patients with ductal carcinoma of the pancreatic head whose tumor size is less than 4 cm without severe invasion to the retroperitoneal space.

Full text

PDF
219

Images in this article

216Fig. 1.
on p.216

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cohen J. R., Kuchta N., Geller N., Shires G. T., Dineen P. Pancreaticoduodenectomy. A 40-year experience. Ann Surg. 1982 May;195(5):608–617. doi: 10.1097/00000658-198205000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cubilla A. L., Fortner J., Fitzgerald P. J. Lymph node involvement in carcinoma of the head of the pancreas area. Cancer. 1978 Mar;41(3):880–887. doi: 10.1002/1097-0142(197803)41:3<880::aid-cncr2820410315>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  3. Edis A. J., Kiernan P. D., Taylor W. F. Attempted curative resection of ductal carcinoma of the pancreas: review of Mayo Clinic experience, 1951-1975. Mayo Clin Proc. 1980 Sep;55(9):531–536. [PubMed] [Google Scholar]
  4. Fortner J. G. Regional pancreatectomy for cancer of the pancreas, ampulla, and other related sites. Tumor staging and results. Ann Surg. 1984 Apr;199(4):418–425. doi: 10.1097/00000658-198404000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Herter F. P., Cooperman A. M., Ahlborn T. N., Antinori C. Surgical experience with pancreatic and periampullary cancer. Ann Surg. 1982 Mar;195(3):274–281. doi: 10.1097/00000658-198203000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ihse I., Lilja P., Arnesjö B., Bengmark S. Total pancreatectomy for cancer. An appraisal of 65 cases. Ann Surg. 1977 Dec;186(6):675–680. doi: 10.1097/00000658-197712000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ishikawa O., Oohigashi H., Imaoka S., Sasaki Y., Kameyama M., Kabuto T., Fukuda I., Furukawa H., Koyama H., Taniguchi K. [Clinico-pathological study on the appropriate range of pancreatic resection to obtain operative curability of pancreatic head cancer]. Nihon Geka Gakkai Zasshi. 1984 Apr;85(4):363–369. [PubMed] [Google Scholar]
  8. MONGE J. J., JUDD E. S., GAGE R. P. RADICAL PANCREATODUODENECTOMY: A 22-YEAR EXPERIENCE WITH THE COMPLICATIONS, MORTALITY RATE, AND SURVIVAL RATE. Ann Surg. 1964 Oct;160:711–722. doi: 10.1097/00000658-196410000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Nagai H., Kuroda A., Morioka Y. Lymphatic and local spread of T1 and T2 pancreatic cancer. A study of autopsy material. Ann Surg. 1986 Jul;204(1):65–71. doi: 10.1097/00000658-198607000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Tepper J., Nardi G., Sutt H. Carcinoma of the pancreas: review of MGH experience from 1963 to 1973. Analysis of surgical failure and implications for radiation therapy. Cancer. 1976 Mar;37(3):1519–1524. doi: 10.1002/1097-0142(197603)37:3<1519::aid-cncr2820370340>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  11. Tryka A. F., Brooks J. R. Histopathology in the evaluation of total pancreatectomy for ductal carcinoma. Ann Surg. 1979 Sep;190(3):373–381. doi: 10.1097/00000658-197909000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Warren K. W., Choe D. S., Plaza J., Relihan M. Results of radical resection for periampullary cancer. Ann Surg. 1975 May;181(5):534–540. doi: 10.1097/00000658-197505000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. van Heerden J. A., ReMine W. H., Weiland L. H., McIlrath D. C., Ilstrup D. M. Total pancreatectomy for ductal adenocarcinoma of the pancreas. Mayo Clinic experience. Am J Surg. 1981 Sep;142(3):308–311. doi: 10.1016/0002-9610(81)90336-6. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES