caa a22 4500 475803299 CHVBK 20180406123743.0 cr unu---uuuuu 170329e20000501xx s 000 0 eng 10.1007/s002689910089 doi (NATIONALLICENCE)springer-10.1007/s002689910089 Surgery for Ductal Adenocarcinoma of the Pancreatic Head: Staging, Complications, and Survival after Regional versus Extended Lymphadenectomy [Elektronische Daten] [Doris Henne-Bruns, Ilka Vogel, Jutta Lüttges, Günter Klöppel, Bernd Kremer] Abstract.: The purpose of this study was to evaluate the influence of regional versus extended lymphadenectomy on survival after partial pancreaticoduodenectomy for pancreatic cancer. From October 1988 to December 1991 (Department of Surgery, University of Hamburg) and from January 1992 to March 1998 (Department of Surgery, University of Kiel) 72 patients with histologically proven ductal adenocarcinoma of the pancreatic head were treated. Partial pancreaticoduodenectomy with regional lymphadenectomy was performed in 26 patients. In 46 patients lymphadenectomy was expanded to include extended retroperitoneal lymphatic and connective tissue clearance. Comparing these two groups and including only patients with R0 resections (n= 58) no significant differences in long-term survival could be shown. The following parameters were shown to have a significant or nearly significant influence on long-term survival: (1) stage of the disease: The 5-year survival of patients with stage I/II pancreatic head cancer was 63%, compared to 15% in patients with stage III/IV a + b of the disease (p= 0.0087). (2) Grading: The 1-year survival of patients with well or moderately differentiated tumors was 55%, compared to 0% for patients with poorly differentiated ductal adenocarcinoma (p= 0.0022). (3) N stage: The 5-year survival of patients in N0 stage was 46.9%, compared with 15% for N1 stage patients. The difference was not quite significant (p= 0.081). (4) Portal vein involvement: The 1-year survival was 0% in patients with R0 resections and histologically proven tumor infiltration of the portal vein, compared to 63% for patients with curative resections without portal vein involvement (p= 0.0063). In conclusion our data indicate that extensive retroperitoneal tissue clearance during pancreaticoduodenectomy for ductal pancreatic cancer does not improve survival compared to regional lymphadenectomy restricted to the right side of the mesenteric artery. 2000 by the Société Internationale de Chir, 2000 Henne-Bruns Doris Department of General and Thoracic Surgery, University of Kiel, Arnold-Heller-Strasse 7, 24105 Kiel, Germany, DE aut Vogel Ilka Department of General and Thoracic Surgery, University of Kiel, Arnold-Heller-Strasse 7, 24105 Kiel, Germany, DE aut Lüttges Jutta Department of Pathology, University of Kiel, Michaelisstrasse 11, 24105 Kiel, Germany, DE aut Klöppel Günter Department of Pathology, University of Kiel, Michaelisstrasse 11, 24105 Kiel, Germany, DE aut Kremer Bernd Department of General and Thoracic Surgery, University of Kiel, Arnold-Heller-Strasse 7, 24105 Kiel, Germany, DE aut World Journal of Surgery Springer-Verlag 24/5(2000-05-01), 595-602 0364-2313 24:5<595 2000 24 268 https://doi.org/10.1007/s002689910089 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910089 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Henne-Bruns Doris Department of General and Thoracic Surgery, University of Kiel, Arnold-Heller-Strasse 7, 24105 Kiel, Germany, DE aut NATIONALLICENCE 700 1- Vogel Ilka Department of General and Thoracic Surgery, University of Kiel, Arnold-Heller-Strasse 7, 24105 Kiel, Germany, DE aut NATIONALLICENCE 700 1- Lüttges Jutta Department of Pathology, University of Kiel, Michaelisstrasse 11, 24105 Kiel, Germany, DE aut NATIONALLICENCE 700 1- Klöppel Günter Department of Pathology, University of Kiel, Michaelisstrasse 11, 24105 Kiel, Germany, DE aut NATIONALLICENCE 700 1- Kremer Bernd Department of General and Thoracic Surgery, University of Kiel, Arnold-Heller-Strasse 7, 24105 Kiel, Germany, DE aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/5(2000-05-01), 595-602 0364-2313 24:5<595 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer