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Figure Legends
Figure 1. Definition of left-sided pancreatic cancer
A) Definition according to the Japan Pancreas Society (JPS). The border between pancreatic body cancer
and tail cancer is the left edge of the aorta (dotted line). When a tumor exists on both sides of the
border, it is defined as pancreatic body and tail cancer. T, tumor; SMV, superior mesenteric vein; Ao,
Aorta.
B) Definition according to the American Joint Committee on Cancer (AJCC)/International Study Group
of Pancreatic Surgery (ISGPS). The border between pancreatic body cancer and tail cancer is the left
edge of the aorta (dotted line).
Figure 2. Recommended extent of lymphadenectomy in distal pancreatectomy
The numeral in the circle indicates the station number of the lymph nodes. Station 7: lymph node along the
left gastric artery; station 8: lymph node along the common hepatic artery; station 9: lymph node around
the celiac axis; station10: lymph node at the splenic hilum; station 11: lymph node along splenic artery;
station 14: lymph node along superior mesenteric artery; station 18: lymph node along the inferior margin
of the pancreas.
JPS, Japan Pancreas Society; AJCC, American Joint Committee on Cancer; ISGPS, International Study
Group of Pancreatic Surgery; LGA, left gastric artery; CHA, common hepatic artery; PHA, proper hepatic
artery; CA, celiac axis; SPA, splenic artery; SMA, superior mesenteric artery; SMV, superior mesenteric
vein
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Table 1 Clinicopathological characteristics
Pt
non-Pt
(n = 61)
(n = 35)
72 (44-87)
71 (42-84)
0.964
38 /23
25 /10
0.361
43 (2-20734)
33 (2-1287)
0.237
9 (15%)
3 (9%)
0.366
Operation time, min (median, range)
201 (112-424)
190 (133-405)
0.566
Blood loss, mL (median range)
352 (5-2815)
335 (20-2140)
0.866
4 (7%)
2 (6%)
0.881
20 (33%)
9 (26%)
0.486
25 (10-63)
18 (6-56)
0.028
Histologic type (well/mod/poor), n
19/36/6
17/14/4
0.182
Regional lymph node metastasis, n
28 (46%)
22 (63%)
0.108
R0 resection, n
51 (84%)
29 (83%)
0.925
0 (0%)
1 (3%)
0.154
Age, years (median, range)
Sex (male/female)
p-value
Preoperative factors
CA19-9, U/mL (median, range)
Neoadjuvant therapy, n
Surgery related factors
Blood transfusion, n
POPF Grade B or C, n
Pathological findings
Tumor diameter (mm), (median range)
Lymph node recurrence, n
Pt, pancreatic tail cancer; non-Pt, pancreatic body cancer and pancreatic body and tail cancer; CA19-9,
carbohydrate antigen 19-9; POPF, postoperative pancreatic fistula
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Table 2 The number of patients with regional lymph node metastasis
Pt
non-Pt
(n = 61)
(n = 35)
Station 7: LNs along left gastric artery*
0/53 (0%)
1/32 (3%)
Station 8: LNs along common hepatic artery*
0/59 (0%)
4/34 (12%)
Station 9: LNs around celiac axis*
0/57 (0%)
2/33 (6%)
Station 10: LNs at the splenic hilum*
4/60 (7%)
1/33 (3%)
Station 11: LNs along splenic artery*
18/61 (30%)
18/35 (51%)
2/56 (4%)
3/33 (9%)
10/60 (17%)
6/35 (17%)
Station 14: LNs along superior mesenteric artery*
Station 18: LNs along inferior margin of the pancreas*
* Number of patients with lymph node metastasis/number of patients in whom the lymph nodes were
detected in the resected specimen
LNs, lymph nodes; Pt, pancreatic tail cancer; non-Pt, pancreatic body cancer and pancreatic body and tail
cancer
14
15
Table 3 The number of metastasized lymph nodes.
Station 7: LNs along left gastric artery*
0/92 (0%)
1/60 (2%)
0/157 (0%)
6/78 (8%)
0/98 (0%)
2/56 (4%)
Station 10: LNs at the splenic hilum*
7/140 (5%)
2/58 (3%)
Station 11: LNs along splenic artery*
51/365 (14%)
36/212 (17%)
2/140 (1%)
5/82 (6%)
16/239 (7%)
13/129 (10%)
Station 8: LNs along common hepatic artery*
Station 9: LNs around celiac axis*
Station 14: LNs along superior mesenteric artery*
Station 18: LNs along inferior margin of the pancreas*
*Total number of metastasized lymph nodes/total number of harvested lymph nodes.
LNs, lymph nodes; Pt, pancreatic tail cancer; non-Pt, pancreatic body cancer and pancreatic body
and tail cancer
15
AJCC/
ISGPS
(B)
JPS
Fig. 1 (A)
16
Pancreatic tail cancer
Pancreatic tail cancer
Pancreatic body and tail cancer
Pancreatic body cancer
Pancreatic body cancer
16
ISGPS
AJCC
JPS
Fig. 2
Pancreatic body cancer
17
Pancreatic tail cancer
17
...
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