摘要淋巴结转移是胰腺癌患者预后差的一个重要因素,主动脉旁淋巴结在可切除胰腺癌中的转移率为9.1％～26.5％,其在胰腺癌中被列为远处转移.但主动脉旁淋巴结转移是否为可切除胰腺癌的绝对手术禁忌尚缺乏Ⅰ级证据支持.目前已发表的文献显示,主动脉旁淋巴结转移患者总体预后差,但部分患者可从手术中获益,手术治疗联合辅助治疗可明显延长患者生存期.因此,可切除胰腺癌发生主动脉旁淋巴结转移时,临床医师可谨慎地为部分患者选择手术治疗.此外,目前研究胰腺癌主动脉旁淋巴结转移预后的文献主要为回顾性研究,尚需要更多前瞻性多中心研究为临床治疗决策提供强有力的证据.

abstractsPancreatic cancer has poor prognosis and lymph node metastasis is a poor prognostic factor in patients with resectable pancreatic cancer.The metastatic prevalence of para-aortic lymph node (PALN) ranges from 9.1％ to 26.5％ and it is listed as the distant metastatic group in pancreatic cancer.Nevertheless,it is controversial whether PALN metastasis is the contraindication of surgery in resectable pancreatic cancer for the shortage of level Ⅰ evidence.This study concluded that PALN metastasis indicated poor prognosis in patients with pancreatic cancer,but some patients with PALN metastases could benefit from surgery and their survival could be much improved after the combination of surgery and adjuvant therapy.Therefore,it is not wise to refuse surgery for all pancreatic cancer patients with PALN metastasis and the clinicians can cautiously choose the patients to do surgery.Besides,there are mainly retrospective studies rather than prospective and multicenter studies to explore the prognosis of pancreatic cancer patients with PALN metastasis.Thus,more prospective and multicenter studies are needed to decide whether PALN metastasis is an independent prognostic factor in patients with resectable pancreatic cancer.