Outcomes of pancreatic adenocarcinoma that was not resected because of isolated para-aortic lymph node involvement

U Marchese; J Ewald; M Gilabert; J-R Delpero; O Turrini

doi:10.1016/j.jviscsurg.2018.06.014

Outcomes of pancreatic adenocarcinoma that was not resected because of isolated para-aortic lymph node involvement

J Visc Surg. 2019 Apr;156(2):97-101. doi: 10.1016/j.jviscsurg.2018.06.014. Epub 2018 Jul 17.

Authors

U Marchese¹, J Ewald², M Gilabert³, J-R Delpero², O Turrini²

Affiliations

¹ Department of Surgical Oncology, Université de la Méditerranée, Institut Paoli-Calmettes, 13009 Marseille, France. Electronic address: [email protected].
² Department of Surgical Oncology, Université de la Méditerranée, Institut Paoli-Calmettes, 13009 Marseille, France.
³ Department of Medical Oncology, Université de la Méditerranée, Institut Paoli-Calmettes, 13009 Marseille, France.

PMID: 30026012
DOI: 10.1016/j.jviscsurg.2018.06.014

Abstract

Purpose: Survival appears to be poor in cases of pancreatic ductal adenocarcinoma (PDAC) with para-aortic lymph node involvement (PALN+). However, resection is still performed in these cases because the prognostic impact of PALN+remains controversial.

Methods: PALN+was intraoperatively found in 14 patients (4.8%) with resectable PDAC who consequently did not undergo pancreatectomy.

Results: The median overall survival time after laparotomy was 21 months. The 1- and 3-year overall survival rates were 58.3% and 25%, respectively.

Conclusions: We support the advisability of reconsidering pancreatectomy in patients with intraoperatively detected PALN+because the reported survival of such patients who undergo pancreatectomy is poorer than the survival observed for patients in our series.

Keywords: Borderline Tumour; Pancreatic adenocarcinoma; Para-aortic lymph node; Station 16 lymph node.

MeSH terms

Adenocarcinoma / drug therapy
Adenocarcinoma / mortality*
Adenocarcinoma / pathology
Adenocarcinoma / surgery
Aged
Antimetabolites, Antineoplastic / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Carcinoma, Pancreatic Ductal / drug therapy
Carcinoma, Pancreatic Ductal / mortality*
Carcinoma, Pancreatic Ductal / pathology
Carcinoma, Pancreatic Ductal / surgery
Contraindications, Procedure
Deoxycytidine / administration & dosage
Deoxycytidine / analogs & derivatives
Female
Fluorouracil / administration & dosage
Gemcitabine
Humans
Irinotecan / administration & dosage
Laparotomy / mortality
Laparotomy / statistics & numerical data
Leucovorin / administration & dosage
Lymph Nodes* / pathology
Male
Oxaliplatin / administration & dosage
Pancreatectomy* / adverse effects
Pancreatectomy* / mortality
Pancreatic Neoplasms / drug therapy
Pancreatic Neoplasms / mortality*
Pancreatic Neoplasms / pathology
Pancreatic Neoplasms / surgery
Progression-Free Survival
Retrospective Studies
Survival Rate
Treatment Outcome
Withholding Treatment*

Substances

Antimetabolites, Antineoplastic
folfirinox
Oxaliplatin
Deoxycytidine
Irinotecan
Leucovorin
Fluorouracil
Gemcitabine