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Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment
SIMPLE SUMMARY: Although the survival benefit of “regional lymph node dissection” for pancreatic head cancer remains unclear, the R0 resection rate is reportedly associated with prognosis. We reviewed the literature that could be helpful in determining the appropriate resection range. The recent dev...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303207/ https://www.ncbi.nlm.nih.gov/pubmed/34298818 http://dx.doi.org/10.3390/cancers13143605 |
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author | Nagakawa, Yuichi Nakagawa, Naoya Takishita, Chie Uyama, Ichiro Kozono, Shingo Osakabe, Hiroaki Suzuki, Kenta Nakagawa, Nobuhiko Hosokawa, Yuichi Shirota, Tomoki Honda, Masayuki Yamada, Tesshi Katsumata, Kenji Tsuchida, Akihiko |
author_facet | Nagakawa, Yuichi Nakagawa, Naoya Takishita, Chie Uyama, Ichiro Kozono, Shingo Osakabe, Hiroaki Suzuki, Kenta Nakagawa, Nobuhiko Hosokawa, Yuichi Shirota, Tomoki Honda, Masayuki Yamada, Tesshi Katsumata, Kenji Tsuchida, Akihiko |
author_sort | Nagakawa, Yuichi |
collection | PubMed |
description | SIMPLE SUMMARY: Although the survival benefit of “regional lymph node dissection” for pancreatic head cancer remains unclear, the R0 resection rate is reportedly associated with prognosis. We reviewed the literature that could be helpful in determining the appropriate resection range. The recent development of high-quality computed tomography has made it possible to evaluate the extent of cancer infiltration. Even if the “dissection 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 the anatomical landmarks to determine the appropriate dissection range intraoperatively. ABSTRACT: Patients with resectable pancreatic cancer are considered to already have micro-distant metastasis, because most of the recurrence patterns postoperatively are distant metastases. Multimodal 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 “dissection 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. |
format | Online Article Text |
id | pubmed-8303207 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83032072021-07-25 Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment Nagakawa, Yuichi Nakagawa, Naoya Takishita, Chie Uyama, Ichiro Kozono, Shingo Osakabe, Hiroaki Suzuki, Kenta Nakagawa, Nobuhiko Hosokawa, Yuichi Shirota, Tomoki Honda, Masayuki Yamada, Tesshi Katsumata, Kenji Tsuchida, Akihiko Cancers (Basel) Review SIMPLE SUMMARY: Although the survival benefit of “regional lymph node dissection” for pancreatic head cancer remains unclear, the R0 resection rate is reportedly associated with prognosis. We reviewed the literature that could be helpful in determining the appropriate resection range. The recent development of high-quality computed tomography has made it possible to evaluate the extent of cancer infiltration. Even if the “dissection 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 the anatomical landmarks to determine the appropriate dissection range intraoperatively. ABSTRACT: Patients with resectable pancreatic cancer are considered to already have micro-distant metastasis, because most of the recurrence patterns postoperatively are distant metastases. Multimodal 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 “dissection 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. MDPI 2021-07-19 /pmc/articles/PMC8303207/ /pubmed/34298818 http://dx.doi.org/10.3390/cancers13143605 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Nagakawa, Yuichi Nakagawa, Naoya Takishita, Chie Uyama, Ichiro Kozono, Shingo Osakabe, Hiroaki Suzuki, Kenta Nakagawa, Nobuhiko Hosokawa, Yuichi Shirota, Tomoki Honda, Masayuki Yamada, Tesshi Katsumata, Kenji Tsuchida, Akihiko Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment |
title | Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment |
title_full | Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment |
title_fullStr | Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment |
title_full_unstemmed | Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment |
title_short | Reconsideration of the Appropriate Dissection Range Based on Japanese Anatomical Classification for Resectable Pancreatic Head Cancer in the Era of Multimodal Treatment |
title_sort | reconsideration of the appropriate dissection range based on japanese anatomical classification for resectable pancreatic head cancer in the era of multimodal treatment |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303207/ https://www.ncbi.nlm.nih.gov/pubmed/34298818 http://dx.doi.org/10.3390/cancers13143605 |
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