Would you electively treat any lymph node regions for small cell carcinoma of the pancreas?

In general, we model treatment for these patients on the regimens used for SCCa of the lung. The most important thing to establish is that non-operative management is the preferred approach due to the risk of distant metastases. In general, the value of elective nodal treatment is inversely proportional to the risk of distant metastases. For this reason, I would not chase regional nodes in SCCa of the pancreas other than the celiac and SMA nodes. However, it is not wrong to be more generous, but...