[Experimental and clinical study on injection of neocarzinostatin into the duodenal sub-serosa as chemotherapy for the regional lymphatic system in pancreatoduodenal cancer].

Abstract

Unlabelled: At the time of pancreatoduodenal cancer resection, Neocarzinostatin (NCS) was injected into the duodenal sub-serosa, as perioperative adjuvant chemotherapy for metastatic lymph nodes and cancer cells released into the lymphatic system. NCS content in the lymph nodes was measured after administration, and usefulness of the chemotherapy was investigated.

Experiment: NCS (4,000 units) was administered into the duodenal sub-serosa of 18 adult mongrel dogs. NCS contents in the lymph nodes (those in the root of the mesentery and around the aorta) and pancreatic tissues were measured. NCS content in the pancreatic tissues decreased significantly 3 hours after administration, while that in the lymph nodes did not decreased even 3 hours later. Consequently, NCS is considered to be remain in the lymph nodes.

Clinical findings: NCS (10,000 units) was administered into the duodenal sub-serosa in 18 resectable cases of pancreatoduodenal cancer. NCS content in the dissected lymph nodes was measured. The total number of dissected lymph nodes was 176, and the mean NCS content was 0.62 mu/g. The number of lymph nodes positive for metastasis was 14, and much content of NCS was observed in the specimens (mean NCS content: 1.25 mu/g). Examination according to site revealed the most content in the lymph nodes in pancreatic head closest to the site of administration, followed by the lymph nodes in the root of the mesentery and those in the hepatoduodenal ligament in the direction of lymphatic flow. Moreover, some distal lymph nodes also showed much content. NCS content in the lymph nodes showed time-related increase after administration, and significant correlation was observed within 2 hours.(ABSTRACT TRUNCATED AT 250 WORDS)