Summary
To clarify the pattern of lymph node metastasis in carcinoma of the pancreas, lymph node involvement was examined in forty-two patients who underwent extensive nodal dissections, including the paraaortic lymph nodes. The correlation between the spread of the tumor and lymph node involvement was evaluated: The most common site of involved lymph nodes was the retropancreatic region. The prevalence of nodal metastases was 78.6%. Metastases to the paraaortic region were present in seven patients, among whom metastases in the paraaortic region were most common in the median region from the celiac artery to the inferior mesenteric artery and in the space between the aorta and the vena cava. The risk of lymph node metastases tended to increase with tumor size, except in the paraaortic region, where the correlation between the frequency of metastasis and tumor size was poor. The probability of lymph node metastases increased with the degree of lymphatic invasion (ly) and the growth pattern of the tumor (INF) and was high in patients with invasion into the retropancreatic tissue and in tumors with scirrhous histology. These results indicate that even in small cancers, lymph nodes of the paraaortic region frequently harbor metastases and should be dissected en block during radical resections of pancreatic cancer.
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References
Nagakawa T, Kurachi M, Konishi K, Miyazaki I. Retroperitoneal dissection for operation of pancreatic cancer: Translateral retroperitoneal approach.Igakunoayumi 1979; 111: 339–341 (in Japanese).
Nagakawa T, Kurachi M, Konishi K, Miyazaki I. Translateral retroperitoneal approach in radical surgery for pancreatic carcinoma.Jpn J Surg 1982; 12: 229–233.
Nagakawa T, Konishi I, Higashino Y, Ueno K, Ohta T, Kayahara M, Ueda N, Maeda K, Miyazaki I. The spread and prognosis of carcinoma in the region of the pancreatic head.Jpn J Surg 1989; 19: 510–518.
Nagakawa T, Konishi I, Ueno K, Ohta T, Akiyama T, Kayahara M, Miyazaki I. Surgical treatment of pancreatic cancer.Int J Pancreatol 1991; 9: 135–143.
Kayahara M, Nagakawa T, Konishi I, Ueno K, Ohta T, Miyazaki I. Clinicopathological study of pancreatic carcinoma with particular reference to the invasion of the extrapancreatic neural plexus.Int J Pancreatol 1991; 10: 105–111.
Kutsuna S.Anatomy of the Lymphatic System in the Japanese. Kanehara Pub., Tokyo, Japan, 1967 (in Japanese).
Inoue Y. Lymphatic system of the stomach, duodenum, pancreas, and diaphragma.Jpn Anatomy 1936; 9: 35–117 (in Japanese).
Deki H, Sato T. An anatomic study of the peripancreatic lymphatics.Surg Radiol Anat 1988; 10: 121–135.
Evans BP Ochsner A. The gross anatomy of the lymphatics of the human pancreas.Surgery 1954; 36: 177–191.
Japan Pancreas Society.General Rules for Surgery and Pathological Studies on Cancer of the Pancreas. 3rd ed., Kanehara, Tokyo, Japan, 1986 (Abstract in English).
Japan Society for Cancer Therapy.General Rules for Reporting Clinical Oncology (JSCT General Rules). Kanehara, Tokyo, Japan, 1991 (in Japanese).
Cubilla AL, Fortner JG, Fitzgerald PJ. Lymph node involvement in carcinoma of the head of the pancreas area.Cancer 1978; 41: 880–887.
Hagihara K. Experimental and clinicopathological stidies on lymphatic flow of the pancreas.Igaku Kenkyu 1982; 52: 61–85 (in Japanese).
Nakao A, Takeda N, Kasuga T. Significance of dissection of paraaortic lymph nodes in pancreatic cancer.Jpn J Surg Assoc 1990; 21: 23–26 (in Japanese).
Nagakaa T, Konishi I, Maeda M, Ohta T, Akiyama T, Kanno M, Kayahara M, Miyazaki I. Lymph node involvement by carcinoma of the pancreatic head area: A grouping of regional lymph nodes involved by the tumors.Memoirs Al Med. Kanazaa Univ. 1990; 14: 1–11.
Nagai H. Involvement of paraaortic lymph nodes by pancreatic cancer and its lymphatic flow.Jpn J Surg 1987; 88: 308–317 (Abstract in English)
Takagi K, Ohhashi I, Ohta H. Pancreatic cancer with bad prognosis.Stomach and Intestine 1984; 19: 1193–1197 (Abstract in English)
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Nagakawa, T., Kobayashi, H., Ueno, K. et al. The pattern of lymph node involvement in carcinoma of the head of the pancreas. Int J Pancreatol 13, 15–22 (1993). https://doi.org/10.1007/BF02795195
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DOI: https://doi.org/10.1007/BF02795195