BACKGROUND: The aim of the present study was to clarify the prognostic impact of para-aortic lymph node metastasis in pancreatic ductal adenocarcinoma. METHODS: Medical records of 103 consecutive patients with pancreatic ductal adenocarcinoma, who underwent pancreatic resection with regional and para-aortic lymph node dissection were reviewed retrospectively. Clinicopathological factors and survival were compared between patients with and without para-aortic lymph node metastasis. RESULTS: Tumor size (p = 0.045), extrapancreatic nerve plexus invasion (p = 0.043), UICC pT factor (p = 0.026), and surgical margin status (p = 0.002) were associated significantly with para-aortic lymph node metastasis. Postoperative adjuvant chemotherapy (p < 0.001) and absence of extrapancreatic nerve plexus invasion (p = 0.041) were associated independently with longer survival, but para-aortic lymph node metastasis (p = 0.078) was not associated significantly with survival by multivariate analysis. The 2- and 5-year survival rates and median survival time of patients with and without para-aortic lymph node metastasis were 12, 0%, 12.4 months and 49, 23%, 14.5 months, respectively, and there was a significant difference in survival between the two groups by a log-rank test (p < 0.001). Postoperative adjuvant chemotherapy significantly improved the survival of patients with para-aortic lymph node metastasis (p = 0.025). CONCLUSIONS: The prognosis of patients with para-aortic lymph node metastasis is poor in pancreatic ductal adenocarcinoma. However, postoperative adjuvant chemotherapy may improve survival.
BACKGROUND: The aim of the present study was to clarify the prognostic impact of para-aortic lymph node metastasis in pancreatic ductal adenocarcinoma. METHODS: Medical records of 103 consecutive patients with pancreatic ductal adenocarcinoma, who underwent pancreatic resection with regional and para-aortic lymph node dissection were reviewed retrospectively. Clinicopathological factors and survival were compared between patients with and without para-aortic lymph node metastasis. RESULTS: Tumor size (p = 0.045), extrapancreatic nerve plexus invasion (p = 0.043), UICC pT factor (p = 0.026), and surgical margin status (p = 0.002) were associated significantly with para-aortic lymph node metastasis. Postoperative adjuvant chemotherapy (p < 0.001) and absence of extrapancreatic nerve plexus invasion (p = 0.041) were associated independently with longer survival, but para-aortic lymph node metastasis (p = 0.078) was not associated significantly with survival by multivariate analysis. The 2- and 5-year survival rates and median survival time of patients with and without para-aortic lymph node metastasis were 12, 0%, 12.4 months and 49, 23%, 14.5 months, respectively, and there was a significant difference in survival between the two groups by a log-rank test (p < 0.001). Postoperative adjuvant chemotherapy significantly improved the survival of patients with para-aortic lymph node metastasis (p = 0.025). CONCLUSIONS: The prognosis of patients with para-aortic lymph node metastasis is poor in pancreatic ductal adenocarcinoma. However, postoperative adjuvant chemotherapy may improve survival.
Authors: Jordan M Winter; John L Cameron; Kurtis A Campbell; Meghan A Arnold; David C Chang; Joann Coleman; Mary B Hodgin; Patricia K Sauter; Ralph H Hruban; Taylor S Riall; Richard D Schulick; Michael A Choti; Keith D Lillemoe; Charles J Yeo Journal: J Gastrointest Surg Date: 2006-11 Impact factor: 3.452
Authors: Helmut Oettle; Stefan Post; Peter Neuhaus; Klaus Gellert; Jan Langrehr; Karsten Ridwelski; Harald Schramm; Joerg Fahlke; Carl Zuelke; Christof Burkart; Klaus Gutberlet; Erika Kettner; Harald Schmalenberg; Karin Weigang-Koehler; Wolf-Otto Bechstein; Marco Niedergethmann; Ingo Schmidt-Wolf; Lars Roll; Bernd Doerken; Hanno Riess Journal: JAMA Date: 2007-01-17 Impact factor: 56.272
Authors: Axel Richter; Marco Niedergethmann; Jörg W Sturm; Dietmar Lorenz; Stefan Post; Michael Trede Journal: World J Surg Date: 2003-02-27 Impact factor: 3.352
Authors: Shahid G Farid; Gavin A Falk; Daniel Joyce; Sricharan Chalikonda; R Matthew Walsh; Andrew M Smith; Gareth Morris-Stiff Journal: HPB (Oxford) Date: 2012-11-19 Impact factor: 3.647