Prognosis Assessment Of Early Pancreatic Ductal Adenocarcionma With Extended Lymphadenectomy

Pancreatic cancer is a common digestive system malignant disease in clinical Practice ,of which the 5-year survival rate is only about 5%, lymph node metastasis is one of the important factors influencing the prognosis for pancreatic cancers, the probability of peripancreatic lymph node metastasis in patients with pancreatic cancer can be 4O-65%. Correct and reasonable lymph node dissection is essential for long-term survival prognosis, and in terms of lymph node dissection ,there are mainly two types Contemporary: standard lymphadenectomy, (SLD) and extended lymph node dissection (ELD) .Extended lymph node dissection is a more thorough lymph node dissection According to biological characteristics and lymph node metastasis pattern of pancreatic cancer, lymph node dissection in the standard.Based on the standard lymphadenectomy ,ELD removes of the liver ligament,retroperitoneal soft tissue,lymph node and nerve plexus involvement completely, emphasises on negative margins, seeks to no lymph node metastasis,no retroperitoneal invasion and microscopic radical resection. All of that is for the goal of radical resection, ELD,in otherwords, also be called D3 (site 3 lymph node dissection) surgery. However, there has been much controversy between both lymph node dissection modes on the prognosis of patients with pancreatic cancer. This retrospective study aims to analysis the prognosis of early pancreatic ductal adenocarcinoma with extended lymphadenectomy.Objective Comparing the clinical datas of early pancreatic ductal adenocarcinoma patients with standard lymphadenectomy and extended lymph node dissection , the aim of thecurrent study is to analysis the prognosis of early pancreatic ductal adenocarcinoma with extended lymphadenectomy.Methods 76 cases of early pancreatic ductal adenocarcinoma patients were receieved surgical operation in our hospital from January 2004 to January 2010, 37 cases were treated by extended lymph node dissection and 39 cases treated by standard lymph node dissection, all off the prognostic datas were compared to analysis the prognosis in patients with the two kind of lymph nodes dissection.Results The results were followed up for 4-36 months.There is no significant difference in the follow factors: gender, age, histology, pathological stage, operative time, intraoperative blood loss, the exhaust time, catheterization time, hospital stay, complications, etc.; there is significant difference of the 2 groups for 1-year, 3-year survival rate, P <0.05; there is significant difference of patients in I + IIa phase for 1-year, 3-year survival rate, P <0.05; IIb survival of 1 year There is no statistically significance of patients in IIb phase for 1-year, survival rate ,P> 0.05, while for the 3-year survival ,ther is significant difference P <0.05.Conclusion1.Comparing with standard lymphadenectomy, extended lymph node dissection is more consistent with lymph node metastasis in early stage pancreatic cancer, a more thorough lymph node dissection, more closely to achieve radical goal.2. Comparing with standard lymphadenectomy ,patiens with early pancreatic cancer(I+IIa phase) receive a longer postoperative survival time by extended lymph node dissection.3. For patients with early pancreatic cancer(IIb phase) ,extended lymph node dissection can prolong ong-term survival time more obviously than standard lymphadenectomy...