Standard versus extended lymphadenectomy in radical pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas Long-term results of a Japanese multicenter randomized controlled trial

被引：211

作者：

Nimura, Yuji ^{[1
,2
]}

Nagino, Masato ^{[2
]}

Takao, Sonshin ^{[3
]}

Takada, Tadahiro ^{[4
]}

Miyazaki, Koji ^{[5
]}

Kawarada, Yoshifumi ^{[6
]}

Miyagawa, Shuichi ^{[7
]}

Yamaguchi, Akihiro ^{[8
]}

Ishiyama, Shuichi ^{[9
]}

Takeda, Yutaka ^{[10
]}

Sakoda, Kourou ^{[11
]}

Kinoshita, Taira ^{[12
]}

Yasui, Kenzo ^{[13
]}

Shimada, Hiroshi ^{[14
]}

Katoh, Hiroyuki ^{[15
]}

机构：

[1] Aichi Canc Ctr, Dept Surg, Chikusa Ku, Nagoya, Aichi 4648681, Japan

[2] Nagoya Univ Hosp, Dept Surg 1, Showa Ku, Nagoya, Aichi 4668550, Japan

[3] Kagoshima Univ Hosp, Dept Surg 1, Kagoshima 8908520, Japan

[4] Teikyo Univ Hosp, Dept Surg 1, Itabashi Ku, Tokyo 1738606, Japan

[5] Saga Med Sch Hosp, Dept Surg 1, Saga 8498501, Japan

[6] Mie Univ Hosp, Dept Surg 1, Tsu, Mie 5148507, Japan

[7] Fujita Hlth Univ Hosp, Dept Surg, Toyoake, Aichi 4701192, Japan

[8] Ogaki Municipal Hosp, Ogaki, Gifu 5038502, Japan

[9] Natl Sendai Hosp, Sendai, Miyagi 9838520, Japan

[10] Osaka Natl Hosp, Chuo Ku, Osaka 5400006, Japan

[11] Kagoshima Med Assoc Hosp, Kagoshima 8900064, Japan

[12] Natl Canc Ctr Hosp E, Kashiwa, Chiba 2778577, Japan

[13] Aichi Canc Ctr Hosp, Chikusa Ku, Nagoya, Aichi 4648681, Japan

[14] Yokohama City Univ Med, Dept Surg 2, Kanazawa Ku, Yokohama, Kanagawa 2360004, Japan

[15] Hokkaido Univ Hosp, Dept Surg 2, Kita Ku, Sapporo, Hokkaido 0608648, Japan

来源：

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES | 2012年 / 19卷 / 03期

关键词：

Pancreatic cancer; Pancreatoduodenectomy; Extended lymphadenectomy; Randomized controlled trial; PERIAMPULLARY ADENOCARCINOMA; RETROPERITONEAL LYMPHADENECTOMY; REGIONAL PANCREATECTOMY; DISTAL GASTRECTOMY; CANCER; RESECTION; CHEMOTHERAPY; CARCINOMA; SURVIVAL; CHEMORADIOTHERAPY;

D O I：

10.1007/s00534-011-0466-6

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The value of pancreatoduodenectomy (PD) with extended lymphadenectomy for pancreatic cancer has been evaluated by many retrospective studies and 3 randomized controlled trials (RCT). However, the protocols used and the results found in the 3 RCTs were diverse. Therefore, a multicenter RCT was proposed in 1998 to evaluate the primary end point of long-term survival and the secondary end points of morbidity, mortality and quality of life of patients undergoing standard versus extended lymphadenectomy in radical PD for pancreatic cancer. From March 2000 to May 2003, 112 patients with potentially curable pancreatic head cancer were enrolled and intraoperatively randomized to a standard or extended lymphadenectomy group. No resected patients received any adjuvant treatments. A hundred and one eligible patients were analyzed. Demographic and histopathological characteristics of the two groups were similar. The mean operating time, intraoperative blood loss and number of retrieved lymph nodes were greater in the extended group, but the other operative results were comparable. Although this multicenter RCT was conducted in a strict setting, extended lymphadenectomy in radical PD did not benefit long-term survival in patients with resectable pancreatic head cancer and led to levels of morbidity, mortality and quality of life comparable to those found after standard lymphadenectomy.

引用

页码：230 / 241

页数：12

共 32 条

[1]

[Anonymous], 2003, Classification of Pancreatic Carcinoma, V2nd

[2]

DOUGLASS HO, 1987, CANCER-AM CANCER SOC, V59, P2006

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