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According to the results of a study published in the Annals of Surgical Oncology, survival after surgery for pancreatic cancer is slightly better among patients who have a larger number of lymph nodes removed.

Pancreatic cancer has one of the highest mortality rates of all cancers. It accounts for approximately 2% of all newly diagnosed cancers in the U.S. each year, but 5% of all cancer deaths.

Pancreatic cancer is often called a “silent killer” because its symptoms are usually not recognizable until it has advanced and spread outside the pancreas. As a result, the majority of pancreatic cancers are not diagnosed until they have reached advanced stages and are considered incurable.

If pancreatic cancer has not spread to distant sites in the body, patients may undergo surgery to remove the cancer. Unfortunately, many patients experience a cancer recurrence following surgery, prompting researchers to explore ways to reduce recurrence risk and improve survival.

During surgery for pancreatic cancer, removal of a large number of lymph nodes may allow for more accurate staging of the cancer. It’s also possible that removal of a larger number of lymph nodes could improve survival by more completely removing areas of cancer. Thus far, however, there is little evidence that extensive lymph node surgery improves survival with pancreatic cancer.

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To explore the relationship between pancreatic cancer survival and number of lymph nodes removed, researchers evaluated information from a large U.S. cancer registry. The researchers collected information about more than 1,600 patients who had undergone surgery for pancreatic cancer. The study excluded patients with cancer that had spread to distant sites in the body and also excluded patients with very large tumors.

  • Survival was better among patients with 15 or more lymph nodes removed than among patients with fewer than 15 lymph nodes removed. The survival benefit was most apparent for patients with node-negative cancer, but there was also a small survival benefit among patients with node-positive cancer.

Among patients who undergo surgery for pancreatic cancer, removal of a larger number of lymph nodes appears to be linked with a modest improvement in survival. The survival improvement was most apparent among patients with node-negative cancer.

Reference: Schwarz RE, Smith DD. Extent of Lymph Node Retrieval and Pancreatic Cancer Survival: Information from a Large U.S. Population Database. Annals of Surgical Oncology. 2006;13:1189-1200.

Related News:Higher Hospital Volume Linked with Better Survival After Gastrointestinal Surgery(11/8/2006)

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