Extended lymphadenectomy in the surgery of pancreatic adenocarcinoma and its relation to quality improvement issues.
Extended lymphadenectomy has been proposed for loco-regional control of pancreatic adenocarcinoma. While retrospective series suggested a benefit, subsequent prospective trials have not shown a survival benefit. Methods to improve loco-regional control of pancreatic body/tail cancer have not been extensively investigated. Lymph node status is an important surrogate of survival but is not a driving factor for adjuvant chemotherapy. Quality improvement in pancreatic cancer surgery is discussed, focusing on the impact of lymph nodes in determining prognosis.
Rupp
Christopher C
CC
Division of General Surgery, Department of Surgery, Section of HPB Surgery, Washington University School of Medicine, St Louis, MO 63110-1010, USA.
Linehan
David C
DC
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011785:Quality Assurance, Health Care