Extended lymph node resection versus standard resection for pancreatic and periampullary adenocarcinoma

Background: Lymphadenectomy has been widely used in the treatment of malignant germ cell tumor of the ovary (OGCT), which is a kind of ovarian cancers occurred mostly in young women and adolescent girls. But the clinical decision mainly depends on the doctor’s experience without a well-defined guideline. This population-based study aimed to evaluate the prognostic impact of lymphadenectomy in different stages of malignant germ cell tumors of the ovary. Methods: Patients with known status of lymphadenectomy in different stages of OGCT were explored from the Surveillance, Epidemiology, and End Results (SEER) program database from 1973 to 2013. We used propensity score matching algorithm to reduce the selection bias between the two study groups. Survival curves, univariate and multivariate Cox proportional hazards model were applied to evaluate the prognostic impact of lymphadenectomy in different stages of OGCT. Results: We included 1,996 OGCT patients in the study, and 818 (41%) of them had lymph node resection. Compared to the LND- group, patients with lymph node resection tended to be at stage II and III, had larger tumor sizes and diagnosed as dysgerminoma. The influence of diagnosis ages, marital status and tumor grades were significantly decreased by applying the propensity score matching. Lymphadenectomy-positive (LND+) group demonstrated significantly worse survival than the lymphadenectomy-negative (LND-) group in later stages (stage III, overall, P=0.027, cancerspecific, P=0.006; stage IV, overall, P=0.034, cancer-specific, P=0.037). While, both the overall and cancer-specific survival showed no significant differences between LND+ and LND- in stage I (overall, P=0.411, cancer-specific, P=0.876) and stage II (overall, P=12, cancer-specific, P=0.061). Univariate (overall, HR=1.497, CI=1.010-2.217, P=0.044; cancer-specific, HR=1.524, CI=1.067- 2.404, P=0.050) and multivariate (overall, HR=1.580, CI=1.046-2.387, P=0.030; cancer-specific, HR=1.661, CI=1.027-2.686, P=0.039) Cox proportional model both verified the association between the lymph node resection and better survival in the whole cohort. Conclusion: Lymphadenectomy significantly increased the survival probability of OGCT patients in stage III and IV, but had no significant influence on early-stage patients (stage I and II), indicating lymphadenectomy should be performed in a stage-dependent manner in clinical utility.

Download Full-text

RIGHT UPPER QUADRANT CYTOREDUCTIVE PROCEDURES AND CARDIOPHRENIC LYMPH NODE RESECTION IN PRIMARY DEBULKIG SURGERY FOR OVARIAN CANCER

Gynecologic Oncology Reports ◽

10.1016/j.gore.2021.100781 ◽

2021 ◽

pp. 100781

Author(s):

Joao Casanova ◽

José Filipe Cunha

Keyword(s):

Ovarian Cancer ◽

Lymph Node ◽

Lymph Node Resection

Download Full-text

Postoperative chest liver herniation after cardiophrenic lymph node resection by a transdiaphragmatic approach following primary cytoreductive surgery for advanced endometrioid ovarian cancer: A case report

Gynecologic Oncology Reports ◽

10.1016/j.gore.2021.100727 ◽

2021 ◽

Vol 36 ◽

pp. 100727

Author(s):

Hélène Leray ◽

Laurent Brouchet ◽

Yann Tanguy Le Gac ◽

Sihem Bouharaoua ◽

Philippe Otal ◽

...

Keyword(s):

Ovarian Cancer ◽

Case Report ◽

Lymph Node ◽

Cytoreductive Surgery ◽

Lymph Node Resection ◽

Liver Herniation ◽

Endometrioid Ovarian Cancer

Download Full-text

676 NECESSITY OF EXTENDED LOWER PARATRACHEAL LYMPH NODE RESECTION DURING ESOPHAGECTOMY FOR CANCER

Diseases of the Esophagus ◽

10.1093/dote/doab052.676 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

C Mann ◽

F Berlth ◽

E Hadzijusufovic ◽

E Uzun ◽

E Tagkalos ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Esophageal Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cell Carcinoma ◽

P Value ◽

Lymph Node Resection ◽

Paratracheal Lymph Node ◽

Esophagectomy For Cancer

Abstract Objective To evaluate the impact of lower paratracheal lymph node resection on oncological radicality and complication rate during esophagectomy for cancer. Backround The ideal extend of lymphadenectomy (LAD) in esophageal surgery is debated. Until today, there has been no proof for improved survival after standardized paratracheal lymph node resection performing oncological esophagectomy. Methods Lymph nodes from the lower paratracheal station are not standardly resected during 2-field Ivor-Lewis esophagectomy for esophageal cancer. Retrospectively, we identified 200 patients operated in our center for esophageal cancer from January 2017—December 2019. Histopathologically, 143 patients suffered from adenocarcinoma, 53 patients from squamous cell carcinoma, two patients from neuroendocrine carcinoma, and one from melanoma of the esophagus. Patients with and without lower paratracheal LAD were compared to patients regarding demographic data, tumor characteristics, operative details, postoperative complications, tumor recurrence and overall survival. Results 103 of 200 patients received lower paratracheal lymph node resection. On average, six lymph nodes were resected in the paratracheal region with histopathological cancer positivity in two patients. Those two patients suffered from neuroendocrine carcinoma and melanoma, none of the AC or SCC patients were positive. There was no significant difference between both groups regarding age, gender, BMI, or comorbidity. Harvesting of lower paratracheal lymph nodes was associated with less postoperative overall complications (p-value 0,029). Regarding overall survival and recurrence rate no difference could be detected between both groups (p-value 0,168, respectively 0,371). Conclusion The resection of lower paratracheal lymph nodes during esophagectomy seems not mandatory for distal squamous cell carcinoma or adenocarcinoma of the esophagus. It may be necessary in NEC, Melanoma of the esophagus or on demand if suspicious LN are detected in the CT scan. No increase of morbidity was caused by paratracheal dissection.

Download Full-text

Comparison of Standard Distal Pancreatectomy and Splenectomy with Radical Antegrade Modular Pancreatosplenectomy

The American Surgeon ◽

10.1177/000313481408000326 ◽

2014 ◽

Vol 80 (3) ◽

pp. 295-300 ◽

Cited By ~ 9

Author(s):

Paul Trottman ◽

Katrina Swett ◽

Perry Shen ◽

Joseph Sirintrapun

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Distal Pancreatectomy ◽

Tumor Staging ◽

The Body ◽

Lymph Node Count ◽

Standard Resection ◽

Lymph Node Retrieval ◽

Significant Difference ◽

Radical Antegrade Modular Pancreatosplenectomy

Radical antegrade modular pancreatosplenectomy (RAMPS) has been reported to provide improved margin resection and lymph node retrieval for tumors of the body and tail of the pancreas compared with standard resection. We examined our experience with RAMPS and standard resection to determine differences in clinicopathologic outcomes. A comparison of RAMPS procedures was made to standard distal pancreatectomy and splenectomy examining various clinicopathologic variables through retrospective chart review. Twenty-six patients underwent distal pancreatectomy with or without splenectomy between November 2004 and June 2011. Twenty patients underwent standard resection and six patients underwent RAMPS procedures for a variety of histologies. As a result of the heterogeneity of diseases, which included benign lesions, margin status was not applicable in some cases and therefore was not assessed overall. Fisher's exact test and Wilcoxon rank sum tests demonstrated a significant difference in number of lymph nodes removed with mean of 4.3 and 11.2 lymph nodes obtained for standard resection and RAMPS, respectively ( P = 0.03). The RAMPS procedure for lesions of the body and tail of the pancreas retrieved significantly more lymph nodes than standard distal pancreatectomy and splenectomy. It should be the preferred surgical approach when lymph node count is important for tumor staging.

Download Full-text