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Title: Preoperative assessment of para-aortic lymph node metastasis in patients with pancreatic cancer
Authors: Imai, Hisashi
Doi, Ryuichiro
Kanazawa, Hiroyuki
Kamo, Naoko  kyouindb  KAKEN_id
Koizumi, Masayuki
Masui, Toshihiko  kyouindb  KAKEN_id  orcid (unconfirmed)
Iwanaga, Yasuhiro
Kawaguchi, Yoshiya  kyouindb  KAKEN_id
Takada, Yasutsugu
Isoda, Hiroyoshi  kyouindb  KAKEN_id
Uemoto, Shinji  kyouindb  KAKEN_id
Author's alias: 土井, 隆一郎
Keywords: Invasive ductal carcinoma of the pancreas
Para-aortic lymph node metastasis
Diagnostic imaging
Issue Date: Jun-2010
Publisher: Springer Verlag
Journal title: International journal of clinical oncology / Japan Society of Clinical Oncology
Volume: 15
Issue: 3
Start page: 294
End page: 300
Abstract: BACKGROUND: Para-aortic lymph node (PALN) metastasis is an important prognostic factor in patients with pancreatic cancer, but accurate preoperative diagnosis is difficult. The objective of this study was to assess the accuracy of diagnosis of PALN by computed tomography (CT), magnetic resonance imaging (MRI), and (18)F-fluorodeoxyglucose positron-emission tomography (FDG-PET). METHODS: From August 2005 to July 2008, 119 patients with invasive ductal adenocarcinoma of the pancreas were included in this study. PALNs with a longer diameter >10 mm on CT or MRI were suspected of being involved by metastasis, whereas FDG uptake exceeding that of the adjacent normal tissue was considered to be positive for metastasis on FDG-PET studies. The imaging findings were compared with the pathological diagnosis of PALN metastasis. RESULTS: PALN dissection was performed in 71 patients (60.0%). Although histopathological examination revealed metastasis in 6 patients (8.5%), none of these patients was positive in any of the preoperative imaging studies. The longer diameter, the shorter diameter, the ratio of the two diameters, and the calculated lymph node volume showed no significant differences between patients with and without PALN metastasis. CONCLUSIONS: Preoperative detection of PALN metastasis in patients with pancreatic cancer is very difficult. Intraoperative histopathological examination of frozen sections is necessary if radical resection is contemplated.
Rights: The original publication is available at
This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1007/s10147-010-0066-5
PubMed ID: 20232101
Appears in Collections:Journal Articles

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