The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas
Objectives: Pancreaticoduodenectomy (PD) followed by lymphadenectomy is performed for patients with pancreatic ductal adenocarcinoma (PDAC) located in the head of the pancreas. Because the head of the pancreas could be divided into dorsal or ventral primordium in relation to embryonic development, t...
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Frontiers Media S.A.
2020-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.01343/full |
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| author | Lihan Qian Lihan Qian Lihan Qian Junjie Xie Junjie Xie Junjie Xie Zhiwei Xu Zhiwei Xu Zhiwei Xu Xiaxing Deng Xiaxing Deng Xiaxing Deng Hao Chen Hao Chen Hao Chen Chenghong Peng Chenghong Peng Chenghong Peng Hongwei Li Hongwei Li Hongwei Li Weimin Chai Jing Xie Weishen Wang Weishen Wang Weishen Wang Baiyong Shen Baiyong Shen Baiyong Shen |
| author_facet | Lihan Qian Lihan Qian Lihan Qian Junjie Xie Junjie Xie Junjie Xie Zhiwei Xu Zhiwei Xu Zhiwei Xu Xiaxing Deng Xiaxing Deng Xiaxing Deng Hao Chen Hao Chen Hao Chen Chenghong Peng Chenghong Peng Chenghong Peng Hongwei Li Hongwei Li Hongwei Li Weimin Chai Jing Xie Weishen Wang Weishen Wang Weishen Wang Baiyong Shen Baiyong Shen Baiyong Shen |
| author_sort | Lihan Qian |
| collection | DOAJ |
| description | Objectives: Pancreaticoduodenectomy (PD) followed by lymphadenectomy is performed for patients with pancreatic ductal adenocarcinoma (PDAC) located in the head of the pancreas. Because the head of the pancreas could be divided into dorsal or ventral primordium in relation to embryonic development, the metastasis of lymph node (LN) may differ. In this retrospective study, we evaluated the impact of extended or standard LN dissection for PDAC located in ventral or dorsal primordia of the pancreatic head.Methods: From February 2016 to November 2018, 178 patients who underwent PD for PDAC were enrolled at the Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University. According to the tumor location and the range of LN dissection, all patients were divided into three groups: ventral primordium with extended lymphadenectomy (VE group), ventral primordium with standard lymphadenectomy (VS group), and dorsal primordium with extended lymphadenectomy (DE group). Clinical and pathological features were retrospectively analyzed as were the long-term survival outcomes.Results: More patients in the VE group were detected with metastasis in the lymph nodes around the superior mesenteric artery (LN14) than those in the DE group (LN along the right side of the superior mesenteric artery, LN14ab): 22.9 vs. 5.9%, p = 0.005; (LN along the left side of the superior mesenteric artery, LN14cd): 10.0 vs. 0.0%, p = 0.022. LN14 was involved in more patients in the VE group than in the VS group (22.9 vs. 5.0%, p = 0.015). For IIb-stage patients in the VE group, the overall survival time (18.3 vs. 9.3 months, p < 0.001) and disease-free survival time (12.2 vs. 5.1 months, p = 0.045) were longer in those with LN14cd (–) than those with LN14cd (+).Conclusion: This study suggested that patients with PDAC located in the ventral head of the pancreas had higher risk of LN14 involvement compared with those at dorsal. Thus, a thorough dissection of LN14 in PDAC located in the ventral head of the pancreas is recommended to optimize the regional extended lymphadenectomy. |
| first_indexed | 2024-12-13T02:26:01Z |
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| language | English |
| last_indexed | 2024-12-13T02:26:01Z |
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| series | Frontiers in Oncology |
| spelling | doaj.art-876be723b38e463a81fdee99ff273cb32022-12-22T00:02:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-08-011010.3389/fonc.2020.01343559400The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the PancreasLihan Qian0Lihan Qian1Lihan Qian2Junjie Xie3Junjie Xie4Junjie Xie5Zhiwei Xu6Zhiwei Xu7Zhiwei Xu8Xiaxing Deng9Xiaxing Deng10Xiaxing Deng11Hao Chen12Hao Chen13Hao Chen14Chenghong Peng15Chenghong Peng16Chenghong Peng17Hongwei Li18Hongwei Li19Hongwei Li20Weimin Chai21Jing Xie22Weishen Wang23Weishen Wang24Weishen Wang25Baiyong Shen26Baiyong Shen27Baiyong Shen28Departement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pathology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaDepartement of General Surgery, Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaResearch Institute of Pancreatic Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaState Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai, ChinaObjectives: Pancreaticoduodenectomy (PD) followed by lymphadenectomy is performed for patients with pancreatic ductal adenocarcinoma (PDAC) located in the head of the pancreas. Because the head of the pancreas could be divided into dorsal or ventral primordium in relation to embryonic development, the metastasis of lymph node (LN) may differ. In this retrospective study, we evaluated the impact of extended or standard LN dissection for PDAC located in ventral or dorsal primordia of the pancreatic head.Methods: From February 2016 to November 2018, 178 patients who underwent PD for PDAC were enrolled at the Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University. According to the tumor location and the range of LN dissection, all patients were divided into three groups: ventral primordium with extended lymphadenectomy (VE group), ventral primordium with standard lymphadenectomy (VS group), and dorsal primordium with extended lymphadenectomy (DE group). Clinical and pathological features were retrospectively analyzed as were the long-term survival outcomes.Results: More patients in the VE group were detected with metastasis in the lymph nodes around the superior mesenteric artery (LN14) than those in the DE group (LN along the right side of the superior mesenteric artery, LN14ab): 22.9 vs. 5.9%, p = 0.005; (LN along the left side of the superior mesenteric artery, LN14cd): 10.0 vs. 0.0%, p = 0.022. LN14 was involved in more patients in the VE group than in the VS group (22.9 vs. 5.0%, p = 0.015). For IIb-stage patients in the VE group, the overall survival time (18.3 vs. 9.3 months, p < 0.001) and disease-free survival time (12.2 vs. 5.1 months, p = 0.045) were longer in those with LN14cd (–) than those with LN14cd (+).Conclusion: This study suggested that patients with PDAC located in the ventral head of the pancreas had higher risk of LN14 involvement compared with those at dorsal. Thus, a thorough dissection of LN14 in PDAC located in the ventral head of the pancreas is recommended to optimize the regional extended lymphadenectomy.https://www.frontiersin.org/article/10.3389/fonc.2020.01343/fullpancreas head cancerpancreatic ductal adenocarcinoma (PDAC)pancreatic embryologylymph node dissection (LN dissection)lymph nodes around superior mesenteric artery (SMA) |
| spellingShingle | Lihan Qian Lihan Qian Lihan Qian Junjie Xie Junjie Xie Junjie Xie Zhiwei Xu Zhiwei Xu Zhiwei Xu Xiaxing Deng Xiaxing Deng Xiaxing Deng Hao Chen Hao Chen Hao Chen Chenghong Peng Chenghong Peng Chenghong Peng Hongwei Li Hongwei Li Hongwei Li Weimin Chai Jing Xie Weishen Wang Weishen Wang Weishen Wang Baiyong Shen Baiyong Shen Baiyong Shen The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas Frontiers in Oncology pancreas head cancer pancreatic ductal adenocarcinoma (PDAC) pancreatic embryology lymph node dissection (LN dissection) lymph nodes around superior mesenteric artery (SMA) |
| title | The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas |
| title_full | The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas |
| title_fullStr | The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas |
| title_full_unstemmed | The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas |
| title_short | The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas |
| title_sort | necessity of dissection of no 14 lymph nodes to patients with pancreatic ductal adenocarcinoma based on the embryonic development of the head of the pancreas |
| topic | pancreas head cancer pancreatic ductal adenocarcinoma (PDAC) pancreatic embryology lymph node dissection (LN dissection) lymph nodes around superior mesenteric artery (SMA) |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.01343/full |
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