Should a Standard Lymphadenectomy Include the No. 16 Lymph Nodes for Patients With Pancreatic Head Adenocarcinoma.
Should a Standard Lymphadenectomy Include the No. 16 Lymph Nodes for Patients With Pancreatic Head Adenocarcinoma.
The aim of this study is to determine whether para-aortic lymph nodes(No.16) should be
 included in the lymphadenectomy during the pancreatoduodenectomy in order to improve the
 long-term survival of patients with pancreatic head ductal adenocarcinoma.
Pancreatic cancer is now raised to the 7th leading cause of death. Surgical resection seems
 to be the unique curative therapy for pancreatic cancer. The pancreaticoduodenectomy is
 widely performed for the patients with pancreatic head cancer in recent decades. The
 lymphadenectomy is an indispensible procedure. In 2014, the International Study Group for
 Pancreatic Surgery (ISGPS) recommended a standard lymphadenectomy should include lymph node
 stations 5, 6, 8a, 12b1, 12b2, 12c, 13a, 13b, 14a, 14b, 17a, and 17b. However, no consensus
 was reached on Lymph node 16 in particular 16b1. There was no stronge evidence available
 concerning the impact on survival.
Inclusion Criteria:

 -  Pathologic diagnosis of pancreatic ductal adenocarcinoma

 -  Signed the informed consents

 Exclusion Criteria:

 -  Pathologic diagnosis of other pancreatic cancers

 -  Pre-operative anti-cancer treatment

 -  Recurrence patients

 -  Patients with contraindication(hepatic/ respiratory/ renal dysfunction, etc )

 -  Pre operative exam: Total bilirubin more than 250µmol/L

 -  AJCC stage IV

 -  Operation non radical