The optional extent of lymph node dissection for pancreatic head cancer

Abstract

Abstract Objective The extent of lymph node dissection for pancreatic head cancer (PHC) is uncertain and controversial; therefore, this study evaluated whether PHC patients can benefit from different extents of lymph node dissection. Methods A total of 106 PHC patients underwent standard regional lymphadenectomy (SRLN; n = 56, 52.8%) and extended regional lymphadenectomy (ERLN; n = 50, 47.2%) between September 2015 and September 2019. None of the study participants had distant metastases. The median survival time and complications were compared between the two groups. Results The median survival time in the SRLN and ERLN groups was 27.01 months and 21.17 months, respectively (P = 0.30). The postoperative major morbidity and mortality rates were 37.50% and 1.79% in the SRLN group, and 46.00% and 2.00% in the ERLN group, respectively. Moreover, the tumor differentiation, tumor diameter, lymph node involvement, perineural invasion, vascular invasion, and margin status all correlated with survival (P < 0.05). Conclusion For PHC patients, ERLN cannot provide a significant survival benefit over SRLN. Moreover, ERLN increased morbidity and mortality, although without statistical significance. This indicates that ERLN should not be considered in PHC patients.