title: Outcome of paraaortic node-positive pancreatic head and bile duct adenocarcinoma.
abstract: BACKGROUND
  This retrospective study aimed to identify the clinicopathologic features and surgical results of paraaortic node-positive periampullary adenocarcinoma.
  
  
  METHODS
  Between 1995 and 1999, 101 patients underwent pancreatectomy with regional and paraaortic lymphadenectomy. Fifteen (15%) patients had histologically proven paraaortic lymph node disease.
  
  
  RESULTS
  The 15 patients included 9 (26%) of 34 patients with pancreatic head carcinoma and 6 (17%) of 36 patients with bile duct adenocarcinoma. All 15 patients had locally advanced tumor invading adjacent structures. The 1-, 2-, and 3-year survival rates were 33%, 27%, and 0%, with median survival of 12 months (range 3 to 33). In patients with pancreatic head carcinoma or bile duct adenocarcinoma, survival curve for those without paraaortic lymph node metastasis was significantly better than that for those with involved paraaortic lymph nodes (P = 0.0033 or P = 0.0149).
  
  
  CONCLUSIONS
  When the paraaortic lymph nodes obtained from sampling biopsy are histologically positive, radical pancreatectomy with extended lymphatic and soft tissue clearance should be abandoned owing to poor outcome.
authors.affiliation: Department of Surgery I, Oita University Faculty of Medicine, Oita, Japan. yoshida-t@nakatsu-hosp.jp
authors.forename: Takanori
authors.initials: T
authors.lastname: Yoshida
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sasaki
authors.forename: Kohei
authors.initials: K
authors.lastname: Shibata
authors.forename: Masanori
authors.initials: M
authors.lastname: Aramaki
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate