[Clinical significance of regional lymphadenectomy in radical resection of ductal adenocarcinoma in the pancreatic head].
OBJECTIVE
To prospectively evaluate the long-term effect of pancreaticoduodenectomy with regional lymphadenectomy.


METHODS
One hundred and twenty-one patients with ductal adenocarcinoma in the pancreatic head treated from 1996 to 2001 were studied prospectively. The enrollment of the patients was dependent on 7 criteria. The patients were divided into two groups: regional lymphadenectomy (group A, n = 50) and routine Whipple procedure (group B, n = 71). Their pre- and postoperative conditions, clinicopathological data, survival rates were studied.


RESULTS
It was comparable between the 2 groups in age, sex, preoperative risk factors, operative management, and postoperative complication. Clinicopathological results showed no difference in tumor size and plexus invasion; but the frequency of lymph node involvement and the amount of resected lymph node in group A were significantly higher than those in group B. The rate of local recurrence was significantly higher in group A than in group B. The survival rates of 1-, 3-, 5-year in group A were 70.8%, 31.4%, 20.9%, respectively, which were higher than those in group B. No direct relations were observed between nodal involvement and survival rate.


CONCLUSIONS
Lymphadenectomy in radical pancreaticoduodenectomy could remove lymph nodes effectively and sufficiently, and reduce the rate of local recurrence so as to improve the long-term survival rate.
Zhang
Yi-jie
YJ
Department of General Surgery, Changhai Hospital, Second Medical University, Shanghai 200433, China.
Hu
Xian-gui
XG
Tang
Yan
Y
Liu
Rui
R
Hu
Zhi-hao
ZH
Jin
Gang
G
Shao
Cheng-hao
CH
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult