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Extended Lymphadenectomy in Patients With Pancreatic Cancer Is Debatable

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Abstract

Lymph node staging is one of the most important factors in determining the prognosis after resection of pancreatic ductal adenocarcinoma. Despite ongoing efforts to further refine lymph node staging, the debate on the extent of lymphadenectomy during pancreaticoduodenectomy is still open. The purpose of this review was to summarize the evidence about performing standard lymphadenectomy during curative resection of pancreatic cancer. All four prospective randomized controlled trials published concluded that extended lymphadenectomy does not contribute to better oncologic outcome for patients with adenocarcinoma of the pancreatic head. Indeed, one major drawback of extended lymphadenectomy is the higher risk of persistent postoperative diarrhea. No prospective randomized studies could be found on the role of extended lymphadenectomy in patients with adenocarcinoma of the corpus and tail. Based on current evidence there is no indication that extended lymphadenectomy should be performed routinely during resection of pancreatic cancer.

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Acknowledgments

We are thankful to Ms. Carol De Simio for the illustration.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, Swiss HPB and Transplant Center, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Gregory Sergeant, Emmanuel Melloul, Mickael Lesurtel, Michelle L. DeOliveira & Pierre-Alain Clavien

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  1. Gregory Sergeant
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  2. Emmanuel Melloul
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  3. Mickael Lesurtel
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  4. Michelle L. DeOliveira
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  5. Pierre-Alain Clavien
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Corresponding author

Correspondence to Pierre-Alain Clavien.

Additional information

Emmanuel Melloul contributed equally as first author. Michelle L. DeOliveira and Pierre-Alain Clavien contributed equally as senior author.

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Sergeant, G., Melloul, E., Lesurtel, M. et al. Extended Lymphadenectomy in Patients With Pancreatic Cancer Is Debatable. World J Surg 37, 1782–1788 (2013). https://doi.org/10.1007/s00268-013-2064-z

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  • DOI: https://doi.org/10.1007/s00268-013-2064-z

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