Evidence map›Paper›PMID 34127329›Full record

ArticleEuropean journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology2021

Complete circumferential lymphadenectomy around the superior mesenteric artery with preservation of nerve plexus reduces locoregional recurrence after pancreatoduodenectomy for resectable pancreatic ductal adenocarcinoma.

Seiko Hirono, Manabu Kawai, Ken-Ichi Okada, Motoki Miyazawa, Yuji Kitahata, Rryohei Kobayashi, Shinya Hayami, Masaki Ueno, Hiroki Yamaue

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Article in European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Seiko HironoSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan. Electronic address: seiko-h@wakayama-med.ac.jp.
Manabu KawaiSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Ken-Ichi OkadaSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Motoki MiyazawaSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Yuji KitahataSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Rryohei KobayashiSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Shinya HayamiSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Masaki UenoSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Hiroki YamaueSecond Department of Surgery, Wakayama Medical University, School of Medicine, Japan.
Wakayama Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvaluation of recurrence pattern and risk factors for recurrence are essential for good rates of survival after upfront pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).

methodsThis retrospective study included 167 consecutive patients who underwent upfront PD for resectable PDAC between 2000 and 2018. Postoperative recurrences were classified into three patterns according to initial recurrence site: isolated locoregional, isolated distant, and simultaneous locoregional and distant recurrences.

resultsThis study found 114 patients who developed postoperative recurrence (68.3%), including 37 patients with isolated locoregional recurrence (32.5%), 67 patients with isolated distant recurrence (58.8%), and 10 patients with simultaneous locoregional and distant recurrences (6.0%). When locoregional recurrence was classified based on the location of recurrent lesions, locoregional recurrence most commonly occurred around the superior mesenteric artery (SMA) (70.2%), followed by around the hepatic artery (25.5%) and in the paraaortic region (14.9%). Multivariate analyses showed that complete circumferential lymphadenectomy around the SMA, including not only the right side, but also the left side, was an independent factor for reduction of locoregional recurrence (P = 0.019, odds ratio [OR]: 2.217). Lymph node metastasis was an independent risk factor for both locoregional (P < 0.001, OR: 3.686) and distant recurrences (P < 0.001, OR: 4.315). Non-completion of postoperative adjuvant therapy was a risk factor for distant recurrence (P < 0.001, OR: 3.748).

conclusionBased on our data, complete circumferential lymphadenectomy around the SMA might contribute to local control, and multidisciplinary treatment including neoadjuvant therapy might be needed for resectable PDAC with high risk for recurrence.

Indexed as

Lymph Node ExcisionNeoplasm Recurrence, LocalAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalChemotherapy, AdjuvantDeoxycytidineDrug CombinationsFemaleGemcitabineHumansLymphatic MetastasisLymph NodesMaleDeoxycytidineDrug CombinationsGemcitabineOxonic AcidS 1 (combination)TegafurCircumferential lymphadenectomy around the SMADistant recurrenceLocoregional recurrenceLymph node metastasisPancreatic ductal adenocarcinomaPancreatoduodenectomy

Identifiers

PMID34127329
OpenAlexW3166442061

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.