title: Current status of radical systematic lymphadenectomy in pancreatic cancer--a review of the literature.
abstract: BACKGROUND
  Pancreatic cancer is the fourth most common cause of death in malignancies with an incidence of 8-12 cases per 100000 in western world. In spite of numerous modifications in therapeutical approaches, prognosis has not improved.
  
  
  METHODS
  In the last few years numerous studies have been performed to reduce tumor mortality with more radical surgical procedures. Several articles of the last 15 years have been investigated to objectivate the benefit of extended lymphadenectomy in pancreatic surgery. Staging of the cancers, prognostic factors, technique and interpretation of lymphadenectomy have been analysed
  
  
  RESULTS
  All studies document a lowered perioperative mortality in pancreatic resections. The procedure is counted as a standardized and safe one. However, several controversies exist. The distinct staging systems in Japan and the western world aggravate the comparison in all studies. Japanese authors in mostly retrospective analyses seem to document a survival benefit by radical surgery. Similar results could not be achieved by western authors.
  
  
  CONCLUSIONS
  Over all, a significant benefit in extreme radical surgery could not bee found. However, there are indications of subgroups of patients in whom extended lymphadenectomy might be beneficial. This subgroup should be defined only by large multicentric, prospective, randomized studies.
authors: Klinik und Poliklinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum Düsseldorf, Heinrich-Heinrich-Universität, Moorenstrasse 5, 40225 Düsseldorf, Germany. matthias.peiper@uni-duesseldorf.de
authors: Matthias
authors: M
authors: Peiper
authors: E
authors: E
authors: Bölke
authors: K
authors: K
authors: Orth
authors: S B
authors: SB
authors: Hosch
authors: A
authors: A
authors: Rehders
authors: H
authors: H
authors: Matthaei
authors: W T
authors: WT
authors: Knoefel
mesh_terms: D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome