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Table 1 High risk lymph node regions of the head pancreatic cancer

From: Clinical target volume delineation including elective nodal irradiation in preoperative and definitive radiotherapy of pancreatic cancer

Pancreatic head tumor

Lymph node group

JPS Classification [[32]]

%

Recommended margins *

Infrapyloric lymph nodes

Group 6

7.2

10 mm margin around the inferior border of the pylorus

Common hepatic artery lymph nodes

Group 8

9.8

10 mm margin around the common hepatic artery, from the origin of the artery (correspond to the superior border of the pancreas), on the anterior surface of the portal vein upper to the hilum of the liver

Celiac trunk lymph nodes

Group 9

3.7

10 mm margin around the celiac trunk

Hepatoduodenal ligament lymph nodes

Group 12

7.9

10 mm margin around the portal vein segment that runs anteromedial to the

inferior vena cava and between the porta hepatis of the liver and the superior part of the duodenum

Posterior pancreaticoduodenal lymph nodes

Group 13

32.3

10 mm margin around the inferior - posterior pancreaticoduodenal artery

Superior mesenteric artery lymph nodes

Group 14

15.8

10 mm margin around the origin of superior mesenteric artery

Paraaortic lymph nodes

Group 16

10.9

10 mm margin around the abdominal aorta, between the celiac artery and the inferior mesenteric artery

Anterior pancreaticoduodenal lymph nodes

Group 17

19.8

10 mm margin around the superior - anterior pancreaticoduodenal artery

  1. * also include any visible nodes (lower axis > 1 cm and/or FDG- avid on PET) plus a margin of 10 mm.
  2. Lymph nodes nomenclature is based on the General Rules for Cancer of the Pancreas published by the Japan Pancreas Society (JPS). The anatomical structures of interest and the abdominal blood vessels of reference were identified for each lymph node region.