Lymph Node Characteristics and Short-Term Outcomes for Resectable Pancreatic Ductal Adenocarcinoma in Vietnam: A Retrospective Single-Center Study

Pancreatic cancer (PC) is one of the leading causes of cancer-related deaths. According to GLOBOCAN, 450,000 individuals were diagnosed with PC and lost annually, and the number is increasing. Radical surgery with standard lymphadenectomy is the only curative treatment and has been implemented in Vietnam recently. The aim of our study was to evaluate lymph node characteristics and short-term outcomes after radical resection for pancreatic ductal adenocarcinoma (PDAC). A retrospective study enrolled 89 PDAC patients who underwent radical resection was conducted in VietDuc University Hospital in Hanoi, Vietnam, from 2013 to 2020. Database on lymph node and short-term surgical outcomes was collected. Male: female ratio was 1.78:1; 51.7% of patients were in the age group 40-60. Most patients were at stage II (70.3%). A total of 85.4% underwent standard pancreaticoduodenectomy, respectively. Histopathological results were mainly low/none differentiation (48.3%). Lymph node (LN) metastasis and neural invasion were observed in 60.7% and 52.8%, respectively. Median examined and positive LN were 9 and 1, respectively; 29.2% had LN ratio >= 0.2. A total of 64% had no complications; 12.4% had POPF at biochemical leak level. Eleven patients (12.4%) had PPH; of them, 4 patients were reoperated, and 1 had an arterial embolization. Ninety-day mortality was 5.7%. Venous resection was the only predictor for near outcomes. The data suggested that standard lymphadenectomy is an indispensable part of the procedures. Pancreaticoduodenectomy with standard lymphadenectomy had an acceptable complication rate. The procedures should be applied as a standard for pancreatic head cancer.