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| 1 | Para-aortic lymph node involvement should not be a contraindication to resection of pancreatic ductal adenocarcinoma显示文摘BACKGROUND Para-aortic lymph nodes(PALN)are found in the aortocaval groove and they are staged as metastatic disease if involved by pancreatic ductal adenocarcinoma(PDAC).The data in the literature is conflicting with some studies having associated PALN involvement with poor prognosis,while others not sharing the same results.PALN resection is not included in the standard lymphadenectomy during pancreatic resections as per the International Study Group for Pancreatic Surgery and there is no consensus on the management of these cases.AIM To investigate the prognostic significance of PALN metastases on the oncological outcomes after resection for PDAC.METHODS This is a retrospective cohort study of data retrieved from a prospectively maintained database on consecutive patients undergoing pancreatectomies for PDAC where PALN was sampled between 2011 and 2020.Statistical comparison of the data between PALN+and PALN-subgroups,survival analysis with the Kaplan-Meier method and risk analysis with univariable and multivariable time to event Cox regression analysis were performed,specifically assessing oncological outcomes such as median overall survival(OS)and disease-free survival(DFS).RESULTS 81 cases had PALN sampling and 17(21%)were positive.Pathological N stage was significantly different between PALN+and PALN-patients(P=0.005),while no difference was observed in any of the other characteristics.Preoperative imaging diagnosed PALN positivity in one case.OS and DFS were comparable between PALN+and PALN-patients with lymph node positive disease(OS:13.2 mo vs 18.8 mo,P=0.161;DFS:13 mo vs 16.4 mo,P=0.179).No difference in OS or DFS was identified between PALN positive and negative patients when they received chemotherapy either in the neoadjuvant or in the adjuvant setting(OS:23.4 mo vs 20.6 mo,P=0.192;DFS:23.9 mo vs 20.5 mo,P=0.718).On the contrary,when patients did not receive chemotherapy,PALN disease had substantially shorter OS(5.5 mo vs 14.2 mo;P=0.015)and DFS(4.4 mo vs 9.8 mo;P<0.001).PALN involvement was not identified as an independent predictor for OS after multivariable analysis,while it was for DFS doubling the risk of recurrence.CONCLUSION PALN involvement does not affect OS when patients complete the indicated treatment pathway for PDAC,surgery and chemotherapy,and should not be considered as a contraindication to resection. | Rupaly Pande Shafiq Chughtai Manish Ahuja Rachel Brown David C Bartlett Bobby V Dasari Ravi Marudanayagam Darius Mirza Keith Roberts John Isaac Robert P Sutcliffe Nikolaos A Chatzizacharias | 2022 | World Journal of Gastrointestinal Surgery2022，14，5： | 2 |
| 2 | River flow forecasting through conceptual models part I-A discussion of principles 显示文摘 | NASH J E SUTCLIFFE J V | 1970 | Journal of Hydrology1970，10，3： | 1 |
| 3 | River flow forecasting through conceptual model显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，10，： | 1 |
| 4 | River flow forecasting through conceptual models part 1: a discussion of principles 显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，10，3： | 1 |
| 5 | River flow forecasting through conceptual models, 1, A discussion of principles显示文摘 | Nash J E Sutcliffe J V | 1970 | J Hydrol1970，10，： | 1 |
| 6 | Hydrological modelling of the Sudd and Jonglei Canal显示文摘 | Sutcliffe J V Parks Y P | 1987 | Hydrological Sciences Journal1987，32，2： | 1 |
| 7 | Rive flow forecasting through conceptual models,Part 1 - a discussion of principles显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，，： | 1 |
| 8 | River flow forecasting throush conceptual models part Ⅰ--A discussion of principles显示文摘 | NASH J E SUTCLIFFE J V | 1970 | Journal of Hydrology1970，10，3： | 1 |
| 9 | River flow forecasting through conceptual models:A discussion of principles显示文摘 | Nash J E Sutcliffe V | 1970 | J Hydrol1970，10，3： | 1 |
| 10 | River flow forecasting through conceptual models part I-A discussion of principles显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of hydrology1970，10，3： | 1 |
| 11 | River flow forecasting through conceptual models part I: A discussion of principles 显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，10，3： | 1 |
| 12 | River flow forecasting through conceptual models显示文摘 | Nash J E Sutcliffe J V | 1970 | J Hydrol1970，10，： | 1 |
| 13 | River flowforecasting through conceptualm- odds, Part 1 a discussion of principles 显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrol- ogy1970，10，3： | 1 |
| 14 | River Flow Forecasting through Conceptual Models, 1, A Discussion of Principles显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，，10： | 1 |
| 15 | A randomized, clinical trialcomparing butylocyanoacrylate with octylcyanoacrylate in the manageraent of selected pediatric facial lacerations显示文摘 | OSMOND M H QUINN J V SUTCLIFFE | 1999 | J Acad Emerg Med1999，6，3： | 1 |
| 16 | River flow forecasting through conceptual models part I-a discussion of principles 显示文摘 | Nash J E Sutcliffe J V | 1978 | Journal of hydrology1978，10，3： | 1 |
| 17 | River Flow Forecasting through Conceptual Models显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，10，： | 1 |
| 18 | River flow forecasting through conceptual models part I - A discussion of principles显示文摘 | Mandeville A N O'Connell P E Sutcliffe J V | 1970 | Journal of Hydrology1970，11，1： | 1 |
| 19 | River flow forecasting through conceptual models, part I:A discussion of principles显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of hydrology1970，10，3： | 1 |
| 20 | River flow forecasting through conceptual models 显示文摘 | Nash J E Sutcliffe J V | 1970 | Journal of Hydrology1970，，10： | 1 |
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