Removal of para-aortic lymph nodes during pancreatic surgery

Para-aortic Lymphnodes Removal During Upfront Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoa: Should it be Performed? A Multicentre Randomized Controlled Trial.

Not applicable Interventional Humanitas Hospital, Italy · NCT04571294

This study is testing whether removing para-aortic lymph nodes during surgery for pancreatic cancer can improve survival and slow down disease progression for patients.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment180 (estimated)
Ages18 Years and up
SexAll
SponsorHumanitas Hospital, Italy Academic / other
Locations1 site (Rozzano, Italy/Milan)
Trial IDNCT04571294 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the impact of removing para-aortic lymph nodes during pancreaticoduodenectomy for patients diagnosed with pancreatic ductal adenocarcinoma (PDAC). The study aims to clarify the role of para-aortic lymphadenectomy, which remains debated in the context of standard lymphadenectomy practices. Participants will undergo surgery to remove the pancreatic head along with the standard lymph nodes, with a focus on assessing the potential benefits of including para-aortic lymph nodes in the procedure. The trial will evaluate outcomes based on survival and disease progression.

Who should consider this trial

Good fit: Ideal candidates are patients with a pre-operative diagnosis of pancreatic head PDAC who are scheduled for upfront pancreaticoduodenectomy with standard lymphadenectomy.

Not a fit: Patients who have undergone neoadjuvant treatment or have confirmed para-aortic lymph node metastases will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could improve survival rates and prognostic outcomes for patients with pancreatic cancer.

How similar studies have performed: Previous studies have shown no survival benefit from extended lymphadenectomy, making this investigation a novel approach to refining surgical techniques in pancreatic cancer treatment.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* pre-operative radiological or histological diagnosis of pancreatic head PDAC, including PDAC arising from IPMN (invasive-IPMN) (in case of not confirmation of PDAC at final pathological examination, the case will be considered as a "drop out" and excluded from the study);
* upfront PD associated with standard lymphadenectomy.

Exclusion Criteria:

* PD performed after neoadjuvant treatment;
* PALN metastases diagnosed by a pre-operative PET-FDG (if performed);
* intraoperative distant metastases;
* R2 resection.

Where this trial is running

Rozzano, Italy/Milan

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Pancreas CancerPancreaticoduodenal LymphadenopathyPancreas Adenocarcinoma
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.