Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma
Abstract Introduction For PDAC patients undergoing resection, it remains unclear whether metastases to the paraaortic lymph nodes (PALN+) have any prognostic significance and whether metastases should lead to the operation not being carried out. Our hypothesis is that PALN + status would be associat...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02123-2 |
| _version_ | 1797752849336107008 |
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| author | Martin Sillesen Carsten Palnæs Hansen Stefan Kobbelgaard Burgdorf Emilie Even Dencker Paul Suno Krohn Sophie Louise Gisela Kollbeck Mogens Tornby Stender Jan Henrik Storkholm |
| author_facet | Martin Sillesen Carsten Palnæs Hansen Stefan Kobbelgaard Burgdorf Emilie Even Dencker Paul Suno Krohn Sophie Louise Gisela Kollbeck Mogens Tornby Stender Jan Henrik Storkholm |
| author_sort | Martin Sillesen |
| collection | DOAJ |
| description | Abstract Introduction For PDAC patients undergoing resection, it remains unclear whether metastases to the paraaortic lymph nodes (PALN+) have any prognostic significance and whether metastases should lead to the operation not being carried out. Our hypothesis is that PALN + status would be associated with short overall survival (OS) compared with PALN-, but longer OS compared with patients undergoing surgical exploration only (EXP). Methods Patients with registered PALN removal from the nationwide Danish Pancreatic Cancer Database (DPCD) from May 1st 2011 to December 31st 2020 were assessed. A cohort of PDAC patients who only had explorative laparotomy due to non-resectable tumors were also included (EXP group). Survival analysis between groups were performed with cox-regression in a multivariate approach including relevant confounders. Results A total of 1758 patients were assessed, including 424 (24.1%) patients who only underwent explorative surgery leaving 1334 (75.8%) patients for further assessment. Of these 158 patients (11.8%) had selective PALN removal, of whom 19 patients (12.0%) had PALN+. Survival analyses indicated that explorative surgery was associated with significantly shorter OS compared with resection and PALN + status (Hazard Ratio 2.36, p < 0.001). No difference between PALN + and PALN- status could be demonstrated in resected patients after controlling for confounders. Conclusion PALN + status in patients undergoing resection offer improved survival compared with EXP. PALN + should not be seen as a contraindication for curative intended resection. |
| first_indexed | 2024-03-12T17:10:26Z |
| format | Article |
| id | doaj.art-96bd69c11bdc46c0a2212573e91e1214 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-12T17:10:26Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-96bd69c11bdc46c0a2212573e91e12142023-08-06T11:04:56ZengBMCBMC Surgery1471-24822023-08-012311810.1186/s12893-023-02123-2Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinomaMartin Sillesen0Carsten Palnæs Hansen1Stefan Kobbelgaard Burgdorf2Emilie Even Dencker3Paul Suno Krohn4Sophie Louise Gisela Kollbeck5Mogens Tornby Stender6Jan Henrik Storkholm7Department of Organ Surgery and Transplantation, Copenhagen University HospitalDepartment of Organ Surgery and Transplantation, Copenhagen University HospitalDepartment of Organ Surgery and Transplantation, Copenhagen University HospitalDepartment of Organ Surgery and Transplantation, Copenhagen University HospitalDepartment of Organ Surgery and Transplantation, Copenhagen University HospitalDepartment of Organ Surgery and Transplantation, Copenhagen University HospitalDepartment of Surgery, Aalborg University HospitalDepartment of Organ Surgery and Transplantation, Copenhagen University HospitalAbstract Introduction For PDAC patients undergoing resection, it remains unclear whether metastases to the paraaortic lymph nodes (PALN+) have any prognostic significance and whether metastases should lead to the operation not being carried out. Our hypothesis is that PALN + status would be associated with short overall survival (OS) compared with PALN-, but longer OS compared with patients undergoing surgical exploration only (EXP). Methods Patients with registered PALN removal from the nationwide Danish Pancreatic Cancer Database (DPCD) from May 1st 2011 to December 31st 2020 were assessed. A cohort of PDAC patients who only had explorative laparotomy due to non-resectable tumors were also included (EXP group). Survival analysis between groups were performed with cox-regression in a multivariate approach including relevant confounders. Results A total of 1758 patients were assessed, including 424 (24.1%) patients who only underwent explorative surgery leaving 1334 (75.8%) patients for further assessment. Of these 158 patients (11.8%) had selective PALN removal, of whom 19 patients (12.0%) had PALN+. Survival analyses indicated that explorative surgery was associated with significantly shorter OS compared with resection and PALN + status (Hazard Ratio 2.36, p < 0.001). No difference between PALN + and PALN- status could be demonstrated in resected patients after controlling for confounders. Conclusion PALN + status in patients undergoing resection offer improved survival compared with EXP. PALN + should not be seen as a contraindication for curative intended resection.https://doi.org/10.1186/s12893-023-02123-2Pancreatic cancerLymph station 16Long term survival |
| spellingShingle | Martin Sillesen Carsten Palnæs Hansen Stefan Kobbelgaard Burgdorf Emilie Even Dencker Paul Suno Krohn Sophie Louise Gisela Kollbeck Mogens Tornby Stender Jan Henrik Storkholm Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma BMC Surgery Pancreatic cancer Lymph station 16 Long term survival |
| title | Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma |
| title_full | Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma |
| title_fullStr | Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma |
| title_full_unstemmed | Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma |
| title_short | Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma |
| title_sort | impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma |
| topic | Pancreatic cancer Lymph station 16 Long term survival |
| url | https://doi.org/10.1186/s12893-023-02123-2 |
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