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- W2895516919 abstract "Introduction: Splenectomy is recommended during resection for left-sided pancreatic ductal adenocarcinoma (PDAC) to perform lymphadenectomy of station 10 (splenic hilum), but there is no level I evidence available to justify this procedure. Our aim was to evaluate both lymph node (LN) involvement and contiguous involvement of splenic hilum in resectable distal PDAC. Methods: We retrospectively reviewed all patients who underwent splenopancreatectomy for PDAC during the last 10 years. Station 10 LN were routinely dissected and isolated, and all corresponding microscopic slides were reinterpreted by a pathologist. CT-scans of patients with tumoral involvement of the spleen or of the splenic hilum by contiguity (TISOSH) and those with less than 10mm between tumor and spleen at pathologic examination were reviewed blindly by a radiologist to evaluate CT-scan for diagnosis of TISOSH. Results: We included 110 consecutive patients, including 104 with analyzable station 10. Tumor was N+ in 58 patients (53%). The median number of nodes identified at station 10 was 2.0±3.0 (range: 0–12). No node was detected at station 10 in 42 patients (40%). No patients had tumor-positive lymph nodes at station 10 (0/104). A TISOSH was found in 9 patients (8%). TISOSH was significantly associated with tail location (p=0.001), tumor size on the CT-scan (p=0.005), multivisceral resection (p=0.001) and multivisceral involvement (p=0.015). Sensitivity, specificity, positive and negative predictive values of CT-scan for diagnosis of TISOSH were respectively 89%, 95%, 89% and 95%. Conclusions: Splenic preservation during resection of left-sided PDAC seems possible in selected patients without suspected TISOSH at preoperative CT." @default.
- W2895516919 created "2018-10-12" @default.
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- W2895516919 date "2018-09-01" @default.
- W2895516919 modified "2023-10-16" @default.
- W2895516919 title "Is routine splenectomy still justified for left-sided pancreatic cancer? Histological reappraisal of splenic hilar lymphadenectomy" @default.
- W2895516919 doi "https://doi.org/10.1016/j.hpb.2018.06.2268" @default.
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