A multicenter prospective study to determine the optimal range of lymph node dissection in pancreatic cancer surgery after neoadjuvant chemotherapy (LYMRIN-Trial): Project study by the Japan Pancreas Society and JON 2302-P

PMCID: PMC12173190

PMID: 40526592

DOI: 10.1371/journal.pone.0325667

Journal: PloS one

Publication Date: 2025-6-17

Authors: Kimura N, Shirai Y, Itoh A, Hirano K, Shibuya K, et al.

Key Points

• Comprehensive multicenter study addressing optimal lymph node dissection in PDAC
• Evaluating metastasis rates across different pancreatic tumor locations to inform surgical strategy
• Potential to develop more targeted, less invasive surgical approaches for PDAC patients

Summary

The LYMRIN trial is a multicenter, prospective interventional study designed to determine the optimal extent of lymph node dissection during pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant chemotherapy with gemcitabine and S-1 (GS). The study aims to address the current uncertainty surrounding the most effective lymph node dissection approach by systematically evaluating lymph node metastasis rates across different pancreatic tumor locations.

The trial will enroll 545 PDAC patients across 42 Japanese institutions, stratified by tumor location (head: 200, body: 165, tail: 180). Patients will undergo either pancreatoduodenectomy or distal pancreatectomy with regional lymph node dissection after neoadjuvant GS therapy. The primary endpoint is the percentage of metastases in each lymph node station, which will help guide a more conservative surgical approach and potentially reduce unnecessary invasive procedures.