Number of Metastatic Lymph Nodes, but Not Lymph Node Ratio, Is an Independent Prognostic Factor after Resection of Pancreatic Carcinoma
- 31 August 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American College of Surgeons
- Vol. 211 (2), 196-204
- https://doi.org/10.1016/j.jamcollsurg.2010.03.037
Abstract
This study evaluated the prognostic significance of the number of metastatic lymph nodes and the ratio of metastatic nodes to total number of examined lymph nodes (lymph node ratio, LNR) after resection of pancreatic carcinoma.Records of 119 consecutive patients with pancreatic ductal carcinoma, who underwent R0 or R1 pancreatectomy with regional node dissection, were reviewed retrospectively. Clinical factors, pathologic factors including number of metastatic nodes and LNR, and survival were analyzed by univariate and multivariate analyses.Overall survival rates were 78%, 28%, and 20% at 1, 3, and 5 years, respectively. The median numbers of evaluated lymph nodes and involved nodes were 28 and 3, respectively. Univariate analysis revealed that tumor location, postoperative adjuvant chemotherapy, tumor differentiation, choledochal invasion, portal or splenic vein invasion, extrapancreatic nerve plexus invasion, resection margin status, node status, number of involved nodes, LNR, International Union against Cancer (UICC) pT factor, and UICC stage correlated significantly (p < 0.05) with increased survival. By multivariate analysis, negative node metastasis (p = 0.008) and 0 or 1 involved node (p = 0.004), but not LNR, correlated independently with longer survival. The 1-, 3-, and 5-year survival rates of patients with 0 or 1 metastatic node and patients with 2 or more metastatic nodes were 91%, 48%, and 40% and 66%, 10%, and 0%, respectively.The number of metastatic nodes, but not LNR, is one of the most powerful prognostic factors after resection of pancreatic carcinoma.Keywords
This publication has 34 references indexed in Scilit:
- The Lymph Node Ratio is the Strongest Prognostic Factor after Resection of Pancreatic CancerJournal of Gastrointestinal Surgery, 2009
- 1423 Pancreaticoduodenectomies for Pancreatic Cancer: A Single-Institution ExperienceJournal of Gastrointestinal Surgery, 2006
- Intraductal papillary-mucinous neoplasms and mucinous cystic neoplasms of the pancreas differentiated by ovarian-type stromaSurgery, 2006
- Extent of Lymph Node Retrieval and Pancreatic Cancer Survival: Information from a Large US Population DatabaseAnnals of Surgical Oncology, 2006
- Long-term survival of pancreatic cancer patient diagnosed by positive telomerase activity of pancreatic juiceSurgery, 2005
- A prospective randomized trial comparing standard pancreatoduodenectomy with pancreatoduodenectomy with extended lymphadenectomy in resectable pancreatic head adenocarcinomaSurgery, 2005
- Undetectable Preoperative Levels of Serum CA 19-9 Correlate with Improved Survival for Patients with Resectable Pancreatic AdenocarcinomaAnnals of Surgical Oncology, 2004
- Surgical treatment of pancreatic adenocarcinoma: actual survival and prognostic factors in 343 patientsEuropean Journal of Cancer, 2004
- Colon Cancer Survival Is Associated With Increasing Number of Lymph Nodes Analyzed: A Secondary Survey of Intergroup Trial INT-0089Journal of Clinical Oncology, 2003
- Development of a novel form of an oral 5-fluorouracil derivative (S-1) directed to the potentiation of the tumor selective cytotoxicity of 5-fluorouracil by two biochemical modulatorsAnti-Cancer Drugs, 1996