ASO Visual Abstract: A Novel Criterion for Lymph Node Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the U.S. SEER Database

2021 ◽  
Author(s):  
Weishen Wang ◽  
Ziyun Shen ◽  
Jun Zhang ◽  
Hao Chen ◽  
Xiaxing Deng ◽  
...  
Keyword(s):  
Lymph Node ◽  
Distal Pancreatectomy ◽  
Lymph Node Dissection ◽  
Population Study ◽  
Ductal Adenocarcinoma ◽  
Seer Database ◽  
Node Dissection ◽  
The U.S

scholarly journals Robotic Versus Laparoscopic Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Qingbo Feng ◽  
Chuang Jiang ◽  
Xuping Feng ◽  
Yan Du ◽  
Wenwei Liao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lymph Node ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Distal Pancreatectomy ◽  
Lymph Node Dissection ◽  
Meta Analysis ◽  
Laparoscopic Distal Pancreatectomy ◽  
Ductal Adenocarcinoma ◽  
R0 Resection ◽  
Node Dissection

BackgroundRobotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP) are the two principal minimally invasive surgical approaches for patients with pancreatic body and tail adenocarcinoma. The use of RDP and LDP for pancreatic ductal adenocarcinoma (PDAC) remains controversial, and which one can provide a better R0 rate is not clear.MethodsA comprehensive search for studies that compared robotic versus laparoscopic distal pancreatectomy for PDAC published until July 31, 2021, was conducted. Data on perioperative outcomes and oncologic outcomes (R0-resection and lymph node dissection) were subjected to meta-analysis. PubMed, Cochrane Central Register, Web of Science, and EMBASE were searched based on a defined search strategy to identify eligible studies before July 2021.ResultsSix retrospective studies comprising 572 patients (152 and 420 patients underwent RDP and LDP) were included. The present meta-analysis showed that there were no significant differences in operative time, tumor size, and lymph node dissection between RDP and LDP group. Nevertheless, compared with the LDP group, RDP results seem to demonstrate a possibility in higher R0 resection rate (p<0.0001).ConclusionsThis systematic review and meta-analysis suggest that RDP is a technically and oncologically safe and feasible approach for selected PDAC patients. Large randomized and controlled prospective studies are needed to confirm this data.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier [CRD42021269353].

scholarly journals Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 950 ◽  
Author(s):  
Jiwoong Jung ◽  
Byoung Hyuck Kim ◽  
Jongjin Kim ◽  
Sohee Oh ◽  
Su-jin Kim ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Population Based ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Seer Database ◽  
Node Dissection ◽  
Cancer Specific Mortality ◽  
Z0011 Trial

The Z0011 trial demonstrated that axillary lymph node dissection (ALND) could be omitted in spite of 1–2 metastatic sentinel lymph nodes. This study aimed to validate the results on a population-based database. The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients comparable to the Z0011 participants. The type of axillary surgery was estimated using the total number of examined axillary lymph nodes (ALNs). Breast cancer-specific mortality (BCSM) was compared between patients with ≥10 ALNs (the sentinel lymph node dissection (SLND) and ALND group, or “SLND + ALND group”) and patients with one or two ALNs (the “SLND group”). During 2010–2015, the SEER database included 7077 and 6620 patients categorized in the SLND group and the SLND + ALND group, respectively. Death was observed for 515 patients (7.3%) in the SLND group and 589 patients (8.9%) in the SLND + ALND group based on a median follow-up of 41 months. After propensity-score matching, the adjusted hazard ratio for BCSM in the SLND group (vs. the SLND + ALND group) was 1.038 (95% confidence interval: 0.798–1.350). Regardless of the SLND criteria, the outcomes were not significantly different between the two groups. This retrospective cohort study of Z0011-comparable patients revealed that ALND could be omitted based on the Z0011 strategy, even among patients with ≤2 dissected ALNs.

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