臨床外科75巻6号

2020年06月発行

特集 膵癌診療ガイドライン改訂を外科医はこう読み解く—ディベート＆ディスカッション

テーマ2：ディベート

大動脈周囲リンパ節のサンプリングが陽性だった—切除を行う vs 行わない

著者： 山本智久¹ 里井壯平¹ 山木壮¹ 坂口達馬¹ 山本宣之¹ 廣岡智¹ 高井惣一郎¹ 関本貢嗣¹ 岡村行泰² 大木克久² 杉浦禎一² 伊藤貴明² 山本有祐² 蘆田良² 上坂克彦²

所属機関： ¹関西医科大学外科 ²静岡県立静岡がんセンター肝胆膵外科

ページ範囲：P.659 - P.667

文献概要

　膵癌の根治切除術において，術中迅速検査で大動脈周囲リンパ節転移陽性と診断された患者に対する切除の意義については，いまだ不明な点が多い．「切除を行う」観点から述べると，転移陽性とされた患者は，転移陰性の患者と比較し有意に予後不良であるが，転移陽性例でも術後補助化学療法を行うことによって予後が改善している報告が散見される．大動脈周囲リンパ節郭清を含めた拡大郭清の意義は認められないものの，大動脈周囲リンパ節転移陽性と診断された場合でも標準的切除を行い，補助化学療法を施行することが予後改善の鍵となりうる．

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