Outcomes of pancreatic adenocarcinoma that was not resected because of isolated para-aortic lymph node involvement

Purpose: Survival appears to be poor in cases of pancreatic ductal adenocarcinoma (PDAC) with para-aortic lymph node involvement (PALN+). However, resection is still performed in these cases because the prognostic impact of PALN+ remains controversial. Methods: PALN+ was intraoperatively found in 14 patients (4.8%) with resectable PDAC who consequently did not undergo pancreatectomy. Results: The median overall survival time after laparotomy was 21 months. The 1- and 3-year overall survival rates were 58.3% and 25%, respectively. Conclusions: We support the advisability of reconsidering pancreatectomy in patients with intraoperatively detected PALN+ because the reported survival of such patients who undergo pancreatectomy is poorer than the survival observed for patients in our series. (C) 2018 Elsevier Masson SAS. All rights reserved.