, Volume 16, Issue 7, pp 1736-1744
Date: 23 Apr 2009

Surgical Treatment of Resectable and Borderline Resectable Pancreas Cancer: Expert Consensus Statement

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LYMPHADENECTOMY: STANDARD OR EXTENDED?

The regional pancreatectomy first described by Fortner in 1973 was complex and not adopted by Western pancreatic surgeons.1 In contrast, Japanese surgeons were influenced by Fortner’s concept of extended lymph node dissection and soft-tissue clearance for resectable pancreatic head cancer. The rationale for a more extensive procedure was based on the observation that standard Whipple resection does not encompass nodal groups often involved with microscopic disease,27 and that many patients frequently experienced local recurrence after resection.8

In the 1980s, several Japanese surgeons reported survival rates after pancreatic head resection superior to those achieved in the Western hemisphere. These reports were criticized because of the use of historical controls and lack of randomization.2,5,813 These studies prompted surgical groups in the Western hemisphere to embark upon prospective, randomized trials addressing the question of more extensive ...

Proceedings of the Consensus Conference sponsored by the American Hepato-Pancreato-Biliary Association and Cosponsored by The Society for Surgery of the Alimentary Tract, The Society of Surgical Oncology, The Gastrointestinal Symposium Steering Committee, and The University of Texas M.D. Anderson Cancer Center held in Orlando, FL, January 24, 2008.