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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 | Supportingscenario-based requirements engineering显示文摘 | SUTCLIFFE A G MAIDEN N A M MINOCHA S | 1998 | IEEE Trans on Soft-ware Engineering1998，24，12： | 1 |
| 3 | Effects of the auditory stimuli of an auditory evoked potential system on levels of consciousness, and on the bispectral index显示文摘 | ABSALOM A R SUTCLIFFE N KENNY G N | 2001 | Br J Anaesth2001，87，5： | 1 |
| 4 | Streptococcus pneumoniae and Streptococcus pyogenes resistant to macrolides but sensitive to clindamycin: a common resistance pattern mediated by an efflux system显示文摘 | Sutcliffe J Tait-Kamradt A Wondrack L | 1996 | Antimicrob Agents Chemother1996，40，： | 1 |
| 5 | The hot workability of Cromanite,a high nitrogen austenitic stainless steel显示文摘 | TARBOTON J N MATTHEWS L M SUTCLIFFE A | | 0，，： | 1 |
| 6 | Detection of erythromycin-resistant determinants by PCR显示文摘 | SUTCLIFFE J GREBE T TAIT-KAMRADT A | 1996 | Antimicrob Agents Chemother1996，40，11： | 1 |
| 7 | Requisite expertise, firm reputation, and status in venture cap- ital investment allocation decisions 显示文摘 | Dimov D P Shepherd D A Sutcliffe K M | 2007 | Journal of Business Venturing2007，22，4： | 1 |
| 8 | Health of IVM children显示文摘 | Basatemur E Sutcliffe A | 2011 | Assist ReprodGenet2011，28，6： | 1 |
| 9 | Uncertainty in the transaction environment:an empirical test显示文摘 | SUTCLIFFE K M ZAHEER A | 1998 | Strategic Management Journal1998，19，1： | 1 |
| 10 | Long-term health implications for children conceived by IVF/ICSI显示文摘 | Steel A J Sutcliffe A | 2009 | Human fertility2009，12，1： | 1 |
| 11 | Investigating user experience in second life for collaborative learning显示文摘 | Sutcliffe A Alrayes A | 2012 | International Journal of Human-Computer Studies2012，，7： | 1 |
| 12 | Inflamma- tion in prostate carcinogenesis 显示文摘 | de MARZO A M PLATZ E A SUTCLIFFE S | 2007 | Nat Rev Cancer2007，7，4： | 1 |
| 13 | Detection of erythromycin-resistant determinants by PCR显示文摘 | SUTCLIFFE J GREBE T TAIT-KAMRADT A | 1996 | Antimicrob Agents Chemother1996，40，： | 1 |
| 14 | Calibrating the late Ordovician glaciation and mass extinction by the eccentricity cycles of Earth's orbit 显示文摘 | Sutcliffe O E Dowdeswell J A Whittington R J | 2000 | Geology2000，28，： | 1 |
| 15 | Detection of erythromycin-resistant determinants by PCR显示文摘 | SUTCLIFFE J GREBE T TAIT-KAMRADT A | 1996 | Antimicrobial Agents and Chemotherapy1996，40，： | 1 |
| 16 | Detection of erythromy- cin-resistant determinants by PCR 显示文摘 | Sutcliffe J Grebe T Tait-Kamradt A | 1996 | Antimicrob Agents Chemoth- er1996，40，11： | 1 |
| 17 | Assisted reproductive therapies and imprinting disorders-a preliminary British survey显示文摘 | Peters C J Bowdin S | 2006 | Hum Reprod2006，21，4： | 1 |
| 18 | Closed- loop control of anesthesia using Bispectral index: performance assess- ment in patients undergoing major orthopedic surgery under com- bined general and regional anesthesia显示文摘 | ABSALOM A R SUTCLIFFE N KENNY G N | 2002 | Anesthesiology2002，96，1： | 1 |
| 19 | Time-Series Forecasting Using Fractional Differencing显示文摘 | Sutcliffe A | 1994 | Journal of Forecasting1994，13，2： | 1 |
| 20 | Detection of erythro- mycin-resistant determinants by PCR显示文摘 | Sutcliffe J Grebe T Tait-Kamradt A | 1996 | Antimicrob Agents Che- mother1996，，： | 1 |
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