Central Surgical AssociationA prospective randomized trial comparing standard pancreatoduodenectomy with pancreatoduodenectomy with extended lymphadenectomy in resectable pancreatic head adenocarcinoma
Section snippets
Materials and methods
This study was approved by the Mayo Foundation Institutional Review Board. Patients were recruited into the trial before operation if the preoperative clinical and radiologic diagnoses were consistent with localized pancreatic head adenocarcinoma. Randomization was performed intraoperatively at the time of exploration after the surgeon had determined that metastatic disease was absent and that the tumor was resectable locally. Tissue confirmation was not required before randomization. Patients
Results
Patients were enrolled in the trial from May 1997 to July 2003. A total of 132 patients signed the consent form to participate in the study, 80 patients were deemed resectable at exploration and thus randomized with 79 patients eligible for analysis. There were 40 patients in the standard pancreatoduodenectomy (PD) group and 39 patients in the pancreatoduodenectomy plus extended lymph node dissection (PD/ELND) group. Demographic and intraoperative factors for the 2 groups were comparable (Table
Discussion
This study was designed to test the hypothesis that more extensive nodal and soft-tissue clearance in patients with adenocarcinoma of the head of the pancreas would improve survival without an increase in morbidity and mortality. Further, this trial was designed to assess changes in quality of life using recognized validated instruments administered preoperatively and postoperatively. A total of 100 patients were to be enrolled in the trial based on our prespecified power calculation but the
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Long-term outcomes of standard versus extended lymphadenectomy in pancreatoduodenectomy for pancreatic ductal adenocarcinoma: A Chinese multi-center prospective randomized controlled trial: A novel randomized controlled trial on lymphadenectomy during pancreatoduodenectomy
2023, Journal of Advanced ResearchTotal Neoadjuvant Treatment for Pancreatic Ductal Adenocarcinoma Is Associated With Limited Lymph Node Yield but Improved Ratio
2022, Journal of Surgical ResearchSurgical treatment of pancreatic cancer: Currently debated topics on morbidity, mortality, and lymphadenectomy
2022, Surgical OncologyCitation Excerpt :To date, no RCT has been published on the usefulness of TME. Since total excision of the mesopancreas corresponds to an incomplete “extended” lymphadenectomy [30–37] (Table 1) with a complete circumferential or right semi-circunferential dissection of the SMA, it is difficult to predict any effect on the long-term survival rate. It has been recalled that mesopancreas lacks well-defined boundaries typical of a single anatomical entity surrounded by fascial structures, as mesorectum, but is connected through its components (i.e., adipose tissue, blood and lymphatic vessels, LN, and extrapancreatic autonomic nerves and plexuses) to the para-aortic area.
Quality of life after pancreatic surgery – A systematic review
2022, HPBCitation Excerpt :Of the 22 studies, only 2 studies with a score of 10 was deemed ‘high quality’.31,35 Eighteen studies were of ‘moderate quality’ – eight studies achieved a score of 9,15,17–19,23,25,26,33 four studies were scored 8,24,27,30,34 and six rated 7.16,20,22,28,29,32 Two studies scored only 5, and were therefore of ‘poor quality’14,21 (Table 2).
ASO Practice Guidelines Series: Management of Resectable, Borderline Resectable, and Locally Advanced Pancreas Cancer
2024, Annals of Surgical Oncology
Presented at the 62nd Annual Meeting of the Central Surgical Association, Tucson, Arizona, March 10-15, 2005.