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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.