Ductal adenocarcinoma of the pancreas head: survival after regional versus extended lymphadenectomy.
OBJECTIVE
The aim of the study was to evaluate the influence of regional versus extended lymphadenectomy on survival in patients with ductal adenocarcinoma of the head of the pancreas. From 1988 to 1996 we performed partial duodeno-pancreatectomies (Whipple procedure) combined with either regional (n = 20, group A) or extended retroperitoneal (n = 33, group B) lymphadenectomy in 53 patients with ductal adenocarcinoma of the pancreas head.


METHODS
The outcome of the two groups was compared by constructing survival curves and evaluating demographic, intraoperative and histopathologic data from all patients (n = 44) with curative (R0) resections.


RESULTS
For patients after R0 resection there was no significant difference in terms of survival between group A and B. Only tumor stage (p = 0.0258), portal vein invasion (p = 0.0190) and tumor grade (p = 0.0021) had a significant influence on survival, regardless of the type of operation.


CONCLUSIONS
Our data suggest that no further improvement of the survival rate can be achieved by extended retroperitoneal lymphadenectomy, compared to regional lymphadenectomy.
Henne-Bruns
D
D
Department of General and Thoracic Surgery, University of Kiel, Germany.
Vogel
I
I
Lüttges
J
J
Klöppel
G
G
Kremer
B
B
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome