Impact of Lymph Node Micrometastasis in Patients with Pancreatic Head Cancer

Kurahara, Hiroshi; Takao, Sonshin; Maemura, Kousei; Shinchi, Hiroyuki; Natsugoe, Shoji; Aikou, Takashi
March 2007
World Journal of Surgery;Mar2007, Vol. 31 Issue 3, p483
Academic Journal
The purpose of this study was to investigate the clinical significance of nodal micrometastasis in patients who underwent a curative operation for pancreatic cancer. Fifty-eight patients underwent a macroscopically curative resection with extended lymph node dissection for pancreatic cancer. The total number of resected lymph nodes was 1,058, and 944 histologically negative lymph nodes were subjected to immunohistochemical staining to detect occult micrometastases. Nodal micrometastases were detected immunohistochemically in 147 out of 944 resected histologically negative lymph nodes (15.6%). Forty-four of all 58 patients (75.9%) and 13 of the 23 histologically node-negative patients (56.5%) had nodal micrometastases. Nodal micrometastases existed in the N1 lymph node area most frequently, followed by the N2 and N3 lymph node areas. The distribution was similar to that of histologically metastatic lymph nodes. Ten out of 16 patients (62.5%) with histological N1, and 5 out of 16 patients (31.3%) with histological N2 had nodal micrometastases beyond the histological lymph node status. Three and 5-year survival rates of pN0 patients without lymph node nodal micrometastases were both 60.0%, while those with nodal micrometastases were 19.2% and 0%, respectively. There was statistically significant difference between the both groups ( P = 0.041). Nodal micrometastasis in pancreatic cancer existed in wider and more distant areas than histological lymph node status, and it was an unfavorable predictive factor, even in N0 patients.


Related Articles

  • Differences in the Status of Involved Lymph Nodes and the Direction of Metastatic Lymphatic Flow from Tumors into Involved Nodes Between Submucosal and T2–4 Thoracic Squamous Cell Esophageal Cancers. Peters, Jeffrey H. // World Journal of Surgery;Mar2009, Vol. 33 Issue 3, p518 

    The article reports on the analysis of the status and pattern metastatic lymph node involvement in node-positive patients undergoing resection with two-or three-field lymphadenectomy for esophageal squamous cell cancer. It assesses the role or a more focused lymphadenectomy during curative...

  • A Novel Survival-Based Tissue Microarray of Pancreatic Cancer Validates MUC1 and Mesothelin as Biomarkers. Winter, Jordan M.; Tang, Laura H.; Klimstra, David S.; Brennan, Murray F.; Brody, Jonathan R.; Rocha, Flavio G.; Xiaoyu Jia; Li-Xuan Qin; D'Angelica, Michael I.; DeMatteo, Ronald P.; Yuman Fong; Jarnagin, William R.; O'Reilly, Eileen M.; Allen, Peter J. // PLoS ONE;Jul2012, Vol. 7 Issue 7, p1 

    Background: One-fifth of patients with seemingly 'curable' pancreatic ductal adenocarcinoma (PDA) experience an early recurrence and death, receiving no definable benefit from a major operation. Some patients with advanced stage tumors are deemed 'unresectable' by conventional staging criteria...

  • Radio-Guided Excision of Metastatic Lymph Nodes in Thyroid Carcinoma: A Safe Technique for Previously Operated Neck Compartments. Erbil, Yeşim; Sarı, Serkan; Ağcaoğlu, Orhan; Ersöz, Feyzullah; Bayraktar, Adem; Salmaslıoğlu, Artür; Gozkun, Osman; Adalet, Işık; Özarmağan, Selçuk // World Journal of Surgery;Nov2010, Vol. 34 Issue 11, p2581 

    Background: Better follow-up of patients with papillary thyroid cancer (PTC) and more sensitive detection leads to detection of recurrences in the neck. Despite excellent outcomes, the major challenge is controlling locoregional recurrence. We aimed to investigate whether the radio-guided...

  • Value of the Cervical Compartments in the Surgical Treatment of Papillary Thyroid Carcinoma. Goropoulos, Apostolos; Karamoshos, Konstantinos; Christodoulou, Andreas; Ntitsias, Theodoros; Paulou, Konstantinos; Samaras, Asterios; Xirou, Persefoni; Efstratiou, Ioannis // World Journal of Surgery;Dec2004, Vol. 28 Issue 12, p1275 

    In the treatment of papillary thyroid carcinoma (PTC), supplementary lymph node dissection (LND) is not well standardized. The purpose of this study was to evaluate the significance of the cervical compartments in the lymphatic spread of PTC and the impact of modified radical neck dissection...

  • Neurogenic pulmonary oedema in a patient with leptomeningeal carcinomatosis. Dammers, R.; van den Bent, Martin J. // Journal of Neurology, Neurosurgery & Psychiatry;Sep2006, Vol. 77 Issue 9, p1097 

    The article provides information on the case of a patient with leptomeningeal carcinomatosis from a primary breast adenocarcinoma. She has a medical history of breast adenocarcinoma wherein she underwent a modified radical mastectomy with axillar lymph node resection. After the normalization of...

  • Endoscopic Mucosectomy of the Esophagus. Seewald, Stefan; Omar, Salem; Soehendra, Nib // American Journal of Gastroenterology;Feb2007, Vol. 102 Issue 2, p236 

    The article provides information about endoscopic mucosal resection (EMR). It is defined as local snare excision of the gastrointestinal wall's mucosa. EMR is indicated for lesions with noninvasive high-grade neoplasias that include high-grade intraepithelial neoplasia and well- and moderately...

  • Short term results of complete (D3) vs. standard (D2) mesenteric excision in colon cancer shows improved outcome of complete mesenteric excision in patients with TNM stages I-II. Storli, K.; Søndenaa, K.; Furnes, B.; Nesvik, I.; Gudlaugsson, E.; Bukholm, I.; Eide, G. // Techniques in Coloproctology;Jun2014, Vol. 18 Issue 6, p557 

    Background: The aim of the present study was to investigate whether the new method of complete mesocolic excision (CME) with a high (apical) vascular tie (D3 resection) had an immediate effect compared with a conventional (standard) approach even in those patients without lymph node metastases....

  • Updates in Surgical Oncology. Blidaru, Alexandru // Romanian Journal of Medical Practice;2011, Vol. 6 Issue 3, p234 

    The article presents information on developments in surgical oncology. The basic principles in surgical oncology are tumor excision, regional lymph node removal, treatment of regional recurrence and distant metastasis. Paradigms have shifted in surgical oncology from maximum tolerable treatment...

  • Surgical Excision versus Antibiotic Treatment for Nontuberculous Mycobacterial Cervicofacial Lymphadenitis in Children: A Multicenter, Randomized, Controlled Trial. Lindeboom, Jerome A.; Kuijper, Ed J.; Van Coppenraet, Elisabeth S. Bruijnesteijn; Lindeboom, Robert; Prins, Jan M. // Clinical Infectious Diseases;4/15/2007, Vol. 44 Issue 8, p1057 

    Background. The optimal treatment of nontuberculosis mycobacterial cervical lymphadenitis in children has not been established. Until recently, surgical excision was the standard treatment, but the number of reports of successful antibiotic treatment is increasing, which questions whether...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics