Introduction: To evaluate the resectability of periampullary tumors, many approaches have been suggested. Sentinel lymph node biopsy has been proposed as a measure early during exploration to avoid proceeding with pancreaticodudenectomy. Lymph node group 8 and 12 according to Japan Pancreas Society Classification are among the first nodal groups exposed during the exploration. Here we evaluate the predictive value of lymph node sampling of these nodal groups and its value to predict resectability of periampullary tumors.
Methods: Over a period of 13 months, 45 patients underwent pancreaticodudenectomy in a single institute and by one surgeon. 36 patients had a final diagnosis of periampullary tumor. In a retrospective analysis, predictive value of regional nodal sampling was evaluated in these patients.
Results: 32 of 36 patients with diagnosis of periampullary tumor had a negative sentinel node for metastatic tumor, while 9 of 32 patients had a positive final nodal status for metastatic tumor. Only 4 patients had both positive nodal sampling and final nodal status for metastatic tumor.
Conclusion: Based on these results, nodal sampling of group 8 and 12 regional nodal basins has a positive predictive value of (1) and a negative predictive value of (0.718) in evaluating regional nodal status. Therefore, decision regarding performing a pancreaticodudenectomy and prediction of final nodal status can not be based on initial nodal sampling.