Risk factors related to metastasis of para-aortic lymph nodes in pancreatic ductal adenocarcinoma: A retrospective observational study

摘要

This study was designed to explore the risk factors related to metastasis of para-aortic lymph node (PALN). Clinicopathologic data of 241 patients with resectable or borderline resectable pancreatic cancer who underwent pancreaticoduodenectomy with extended lymphadenectomy between January 2008 and December 2015 were collected, potential factors related to metastasis of PALN were analyzed. Positive rate of PALN was 19.5% (47/241). Univariate analysis showed that back pain ( P = .028), preoperative CA19-9 level ( P 1.0 cm were in correlation with PALN involvement, multivariate analysis revealed that preoperative CA19-9 level, PV/SMV invasion, SMA invasion and diameter 1.0 cm were independent risk factors to metastasis of PALN. Patients with LN8+ had a higher positive rate of PALN than with LN8? (38.1% vs 15.6%, P = .001), similar results could be found when LN12+ (35.8% vs 13.2%, P 1.0 cm were 4 independent risk factors to PALN metastasis . LN8+ and LN14+ were 2 strong predictors of PALN metastasis . A comprehensive analysis covering all possible risk factors related to metastasis of PALN should be given before design of treatment plan whenever involvement of PALN was suspected.