Editor: Aigerim Akhmetova
Author: Aigerim Akhmetova
Adenocarcinoma of the pancreas and periampullary adenocarcinomas are the most common and aggressive among the types of pancreatic cancer. The most common symptoms include pain, jaundice (yellowing of the skin and whites of the eyes) , and weight loss.
Partial pancreatoduodenectomy (PD) is the method of choice. It involves removing the head of the pancreas, the duodenum, the gallbladder, the far end of the bile duct, the lymph nodes near the affected area, and sometimes the far end of the stomach. However, there is still debate about whether removing more lymph nodes than a partial pancreatoduodenectomy is potentially beneficial. Since, in general, about 5% of people die from pancreatic surgery, and from 18% to 52% face complications.
Therefore, the aim of this study was to compare overall survival after standard and extended lymphadenectomy on the head of the pancreas and periampular adenocarcinoma.
Seven randomized controlled trials (a type of trial in which participants are randomly assigned to treatment groups) were included, published before September 10, 2020, for a total of 843 adult participants who had PD with standard or extended lymph node removal.
The study found virtually no difference in overall survival between the two groups of patients. It is likely that during the operation, the blood loss was greater and more lymph nodes were removed in the group that underwent extended lymph node resection. However, there were practically no differences in the frequency of negative resection edges between the two groups (i.e., no tumor cells were found on the cutting surface of the sample).
The researchers concluded that currently, more extensive removal of lymph nodes does not improve the survival of people with pancreatic and periampular adenocarcinomas(low-quality evidence).
Source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011490.pub2/...
