ISSN: 1859 - 2872
Characteristics of exocrine pancreatic head cancer and the treatment results of standard lymphadenectomy
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Abstract
Objective: To describe the characteristics of patients with pancreatic head cancer and the treatment results of lymphadenectomy. Subject and method: A combined prospective and retrospective, convenient sampling study with 89 patients undergoing radical surgery at Viet Duc University Hospital from January 2013 to August 2020 was conducted. Result: Mean age was 57.5; male:female ratio was 1.78:1. 65.2% had jaundice, the median of total bilirubin level was 147umol/l; 4.5% had preoperative biliary drainage. 60.7% of patients had lymph node metastasis and 52.8% had neural invasion. The low/un-differentiation rate was 48.3%. R0 resection rate was achieved in 83.1% of patients. Most patients in stage III (64.1%). Lymph node (LN) 13, 17 and LN 12 had the greatest number of resected LN (3.91 and 2.45; respectively). LN 13, 17 also had the highest rate of positive LN (53.6%). 29.2% had more than 15 resected LNs; 43.8% and 13.5% of patients had 1-3 and ≥ 4 metastasis LN, respectively. 29.2% had lymph node ratio (LNR) higher than 0.2. The 90-day mortality rate was 5.7%. There was a statistically significant difference in overall survival between N0 and N1 (28.7 and 18.8 months; p=0.016). Conclusion: The number of patients undergoing surgery at the early stage was low and the rate of LN metastasis was high. LN 13, 17 and 12 need to be carefully resected. Standard lymphadenectomy is a safe procedure and has an important role in improving the radical resection rate, staging and prognosis.
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