Reconsideration of the appropriate dissection range based on Japanese anatomical classification for resectable pancreatic head cancer in the era of multimodal treatment

Yuichi Nagakawa, Naoya Nakagawa, Chie Takishita, Ichiro Uyama, Shingo Kozono, Hiroaki Osakabe, Kenta Suzuki, Nobuhiko Nakagawa, Yuichi Hosokawa, Tomoki Shirota, Masayuki Honda, Tesshi Yamada, Kenji Katsumata, Akihiko Tsuchida

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)

Abstract

Patients with resectable pancreatic cancer are considered to already have micro-distant metastasis, because most of the recurrence patterns postoperatively are distant metastases. Multi-modal treatment dramatically improves prognosis; thus, micro-distant metastasis is considered to be controlled by chemotherapy. The survival benefit of “regional lymph node dissection” for pancreatic head cancer remains unclear. We reviewed the literature that could be helpful in determining the appropriate resection range. Regional lymph nodes with no suspected metastases on preoperative imaging may become areas treated with preoperative and postoperative adjuvant chemotherapy. Many studies have reported that the R0 resection rate is associated with prognosis. Thus, “dissection to achieve R0 resection” is required. The recent development of high-quality computed tomography has made it possible to evaluate the extent of cancer infiltration. Therefore, it is possible to simulate the dissection range to achieve R0 resection preoperatively. However, it is often difficult to distinguish between areas of inflammatory changes and cancer infiltration during resection. Even if the “dissec-tion to achieve R0 resection” range is simulated based on the computed tomography evaluation, it is difficult to identify the range intraoperatively. It is necessary to be aware of anatomical landmarks to determine the appropriate dissection range during surgery.

Original languageEnglish
Article number3605
JournalCancers
Volume13
Issue number14
DOIs
Publication statusPublished - 02-07-2021

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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