胰头癌根治性手术的淋巴结清扫

Lymphadenectomy for Adenocarcinoma of the Pancreatic Head

胰头恶性肿瘤以手术治疗为主要治疗方式,其淋巴结清扫问题近年来受到热议。本文比较扩大淋巴结清扫与标准根治对患者生存的影响。讨论最新制定的胰头癌标准淋巴结清扫范围。认识淋巴结转移数目、淋巴结转移率作为预后判断因素的作用。介绍腹主动脉旁淋巴结活检以及最小淋巴结检测数研究的进展。最终认为胰头癌根治性手术的淋巴结清扫因手术方式多样的原因研究较为困难,在新的标准根治范围指导下仍需不断实践完善补充,以提高胰腺恶性肿瘤的生存率。

Surgical resection remains an important approach in the treatment for patients with pancreatic cancer, and lymphadenectomy in patients with pancreatic cancer is debatable. The purpose of this review was to summarize the evidence about performing standard lymphadenectomy during curative resection of pancreatic cancer versus extended lymphadenectomy. The paper has discussed the definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma. The author has used the number of metastatic lymph and lymph node ratio to assess the nodal status. The paper has shared the latest progress of para-aortic lymph node sampling and number of examined lymph nodes. We recognized the difficulties in the study of lymphadenectomy in patients with pancreatic cancer because of the various surgical procedure. We need ongoing efforts to question the new definition of a standard lymphadenectomy, in order to improve the survival rate of pancreatic ductal adenocarcinoma patient.