胰腺尾部癌的最佳淋巴结清扫术。
Optimal lymph-node dissection for pancreatic tail cancer.
机构信息
Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Digestive Disease Center, Hiroshima Memorial Hospital, Hiroshima, Japan.
出版信息
Surg Today. 2022 Sep;52(9):1307-1312. doi: 10.1007/s00595-022-02463-1. Epub 2022 Feb 18.
PURPOSE
The optimal range of lymph-node dissection for pancreatic tail cancer remains unclear. We investigated the location and frequency of lymph-node metastases to identify the correct range of lymph-node dissection for pancreatic tail cancer.
METHODS
We analyzed clinical data retrospectively, on patients who underwent distal pancreatectomy for resectable left-sided pancreatic cancer, between February, 2006 and March, 2021. Eligible patients were divided into two groups according to the tumor location: those with pancreatic tail cancer (Pt group) and those with pancreatic body or body and tail cancer (non-Pt group).
RESULTS
Of the 96 patients analyzed, 61 (64%) were assigned to the Pt group and 35 (36%) were assigned to the non-Pt group. Metastases to stations 7, 8, 9, 10, 11, 14, and 18 were found in 0 (0%), 0 (0%), 0 (0%), 4 (7%), 18 (30%), 2 (4%), and 10 (17%) patients in the Pt group, and in 1 (3%), 4 (12%), 2 (6%), 1 (3%), 18 (51%), 3 (9%), and 6 (17%) patients in the non-Pt group, respectively.
CONCLUSION
Lymph-node dissection at stations 7, 8, and 9 might not be necessary in patients with resectable pancreatic cancer confined to the pancreatic tail.
目的
胰尾癌淋巴结清扫的最佳范围仍不清楚。我们研究了淋巴结转移的位置和频率，以确定胰尾癌淋巴结清扫的正确范围。
方法
我们回顾性分析了 2006 年 2 月至 2021 年 3 月期间因可切除左侧胰腺癌行胰体尾切除术的患者的临床资料。根据肿瘤位置将符合条件的患者分为两组：胰尾癌（Pt 组）和胰体或体尾部癌（非-Pt 组）。
结果
在分析的 96 例患者中，61 例（64%）被分配到 Pt 组，35 例（36%）被分配到非-Pt 组。Pt 组的站 7、8、9、10、11、14 和 18 转移的患者分别为 0（0%）、0（0%）、0（0%）、4（7%）、18（30%）、2（4%）和 10（17%），而非-Pt 组分别为 1（3%）、4（12%）、2（6%）、1（3%）、18（51%）、3（9%）和 6（17%）。
结论
对于局限于胰尾的可切除胰腺癌患者，清扫站 7、8 和 9 的淋巴结可能没有必要。
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