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Significance of Common Hepatic Artery Lymph Node Metastases During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma

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Background

Common hepatic artery lymph nodes (CHALN) are frequently sampled during pancreaticoduodenectomy for adenocarcinomas of the head of the pancreas. In some institutions, if metastatic disease is detected intraoperatively in these lymph nodes, the tumor is considered unresectable and a curative operation is not performed. No solid data exist to support this practice.

Methods

A retrospective review of a prospectively collected database was conducted of the records of all patients who underwent a pancreaticoduodenectomy for pancreatic adenocarcinoma between September 1991 and April 2005. Clinical and pathologic factors were analyzed to determine their influence on survival.

Results

Fifty-five of 175 patients had CHALN separately identified and evaluated; these patients constituted the study population. Thirty-eight patients (69%) had one or more lymph nodes with metastatic involvement; 10 of these had disease in CHALN. The median overall survival for patients with node-negative, node-positive (but CHALN-negative), and CHALN-positive disease were 22.9, 16.1, and 14.7 months, respectively. The 5-year overall survival rates for the respective groups were 22%, 17%, and 0%.

Conclusions

CHALN metastases correlate with poor prognosis and no long-term survival. Further studies examining CHALN status are indicated and could lead to modifications of pancreatic cancer staging and management.

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Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, Pennsylvania, 19111

    Fernando Cordera MD, Cletus A. Arciero MD, James C. Watson MD & John P. Hoffman MD

  2. Department of Statistics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, Pennsylvania, 19111

    Tianyu Li MS

Authors
  1. Fernando Cordera MD
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  2. Cletus A. Arciero MD
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  3. Tianyu Li MS
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  4. James C. Watson MD
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  5. John P. Hoffman MD
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Corresponding author

Correspondence to Fernando Cordera MD.

Additional information

Poster presentation at the Society of Surgical Oncology Meeting, March 22–25, 2006, San Diego, California. Presented in part at the Pancreas Club Meeting, May 21, 2006, Los Angeles, California.

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Cordera, F., Arciero, C.A., Li, T. et al. Significance of Common Hepatic Artery Lymph Node Metastases During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma. Ann Surg Oncol 14, 2330–2336 (2007). https://doi.org/10.1245/s10434-006-9339-7

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  • DOI: https://doi.org/10.1245/s10434-006-9339-7

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