Shrikhande SV, Barreto SG. Extended pancreatic resections and lymphadenectomy: An appraisal of the current evidence. World J Gastrointest Surg 2010; 2(2): 39-46 [PMID: 21160848 DOI: 10.4240/wjgs.v2.i2.39]
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Shailesh V Shrikhande, MBBS, MS, MD, Department of Hepato-Pancreato-Biliary Surgical Oncology, Tata Memorial Hospital, Ernest Borges Marg, Parel-Mumbai 400 012, India. shailushrikhande@hotmail.com
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World J Gastrointest Surg. Feb 27, 2010; 2(2): 39-46 Published online Feb 27, 2010. doi: 10.4240/wjgs.v2.i2.39
Extended pancreatic resections and lymphadenectomy: An appraisal of the current evidence
Shailesh V Shrikhande, Savio G Barreto
Shailesh V Shrikhande, Department of Hepato-Pancreato-Biliary Surgical Oncology, Tata Memorial Hospital, Mumbai 400 012, India
Savio G Barreto, Department of General and Digestive Surgery, Flinders Medical Centre and Flinders University, Adelaide, SA 5042, Australia
Author contributions: Shrikhande SV designed the study, analysed and interpreted the data, revised it critically for important intellectual content and approved the final version; Barreto SG acquired and analysed the data, drafted the article and approved the final version.
Correspondence to: Shailesh V Shrikhande, MBBS, MS, MD, Department of Hepato-Pancreato-Biliary Surgical Oncology, Tata Memorial Hospital, Ernest Borges Marg, Parel-Mumbai 400 012, India. shailushrikhande@hotmail.com
Telephone: + 91-22-24177173 Fax: +91-22-24148114
Received: November 13, 2009 Revised: December 11, 2009 Accepted: December 18, 2009 Published online: February 27, 2010
Abstract
Surgery remains the mainstay of treatment for pancreatic ductal adenocarcinoma and complete removal of the cancer confers a definite survival advantage, especially in early disease. However, the majority of patients do not present with early disease, thus precluding the chance of a cure by standard pancreatoduodenectomy (PD), distal pancreatectomy or total pancreatectomy. For this reason, pancreatic surgeons have attempted to push the limits of resection over the last three decades. The aim of these resections has been to determine whether obtaining a complete resection by extending the limits of conventional resection in patients with advanced disease will yield the results seen with PD alone in early disease. This article revisits the data from such studies in an attempt to determine if the available literature supports the performance of extended resections for pancreatic cancer in terms of improvement of survival.
