Prognostic and therapeutic role of lymphadenectomy in surgical treatment of pancreatic head cancer

Citato su WebOfKnowledge ----- Between January 1974 and December 1997, 77 patients with pancreatic head carcinoma underwent pancreaticoduodenectomy. The overall post-operative mortality rate was 5.2% and morbidity was 23.4%. Median survival following resection was 17 months and the estimated 5-year survival was 18.2 % (14 patients). Of the 77 patients, 25 (32.5%) had negative lymph nodes. The median and 5-year survival in these node-negative patients were 33 months and 40%, respectively. Whereas the median survival and 5-year survival in 52 patients with lymph nodes metastases were 14 months and 7.7%, respectively (P < 0.0001). There were 4 five-year survivors in the group of patients with lymph node metastases: in 2 patients was performed extensive lymph node dissection (R2) and in other 2 patients R1 procedure. In the patients with lymph node metastases undergoing R1 resection (n=39), the 5-year survival rate was 5.1%. Whereas in the patients with positive lymph nodes undergoing R2 resection (n=14), the 5-year survival rate was 14.3% (P < 0.02).