Xu YH, Jiao Y. Reassessing the role of lymph node dissection in pancreatic cancer surgery: Balancing oncologic control and immune function preservation. World J Gastrointest Oncol 2025; 17(11): 112248 [DOI: 10.4251/wjgo.v17.i11.112248]
Corresponding Author of This Article
Yan Jiao, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Xinmin Street, Changchun 130021, Jilin Province, China. jiaoyan@jlu.edu.cn
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Gastroenterology & Hepatology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 13, 2025
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Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Xu YH, Jiao Y. Reassessing the role of lymph node dissection in pancreatic cancer surgery: Balancing oncologic control and immune function preservation. World J Gastrointest Oncol 2025; 17(11): 112248 [DOI: 10.4251/wjgo.v17.i11.112248]
World J Gastrointest Oncol. Nov 15, 2025; 17(11): 112248 Published online Nov 15, 2025. doi: 10.4251/wjgo.v17.i11.112248
Reassessing the role of lymph node dissection in pancreatic cancer surgery: Balancing oncologic control and immune function preservation
Yi-Han Xu, Yan Jiao
Yi-Han Xu, Department of The First Operation Room, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Yan Jiao, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Xu YH wrote the initial draft; Jiao Y contributed to the study design, literature review, and revisions to the final manuscript; all authors approved the final version to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Jiao, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Xinmin Street, Changchun 130021, Jilin Province, China. jiaoyan@jlu.edu.cn
Received: July 22, 2025 Revised: August 7, 2025 Accepted: September 28, 2025 Published online: November 15, 2025 Processing time: 115 Days and 11.8 Hours
Abstract
Lymph node dissection (lymphadenectomy) remains a critical component of pancreatic cancer surgery, contributing to accurate staging and guiding adjuvant therapy. The debate between standard and extended lymphadenectomy persists, with evidence showing no significant survival advantage of extended dissection over the standard approach. Extended lymphadenectomy, while increasing the number of lymph nodes retrieved, is associated with longer operative times, greater blood loss, and higher morbidity. More importantly, lymph nodes serve as critical immune hubs, and excessive removal may compromise systemic immune surveillance, which is vital in the context of emerging immunotherapies for pancreatic cancer. This minireview synthesizes the oncological and immunological perspectives on lymphadenectomy, advocating for a personalized approach to lymph node management in pancreatic cancer surgery, focusing on balancing oncologic outcomes with immune preservation.
Core Tip: The extent of lymph node dissection in pancreatic cancer surgery remains contentious. While extended lymphadenectomy does not improve survival outcomes, it increases morbidity and may impair immune function. This minireview calls for a more individualized approach to lymphadenectomy, considering both oncologic efficacy and immune preservation, in line with the evolving landscape of immunotherapy.
