BACKGROUND: For ampullary carcinoma (AC), the lymph node ratio (LNR) has been associated with overall survival. However, the use of the LNR to predict distant recurrence risk remains unknown. The purpose of this study was to determine if the LNR is associated with distant recurrence risk. METHODS: One hundred forty three patients with AC who underwent pancreaticoduodenectomy between 1989 and 2011 were identified from a single-institution prospective database. Data on clinicopathologic factors and recurrence were analyzed. RESULTS: At a median follow-up of 43 months (62 months for survivors), 55 patients (38 %) had developed recurrent disease, with a median time to recurrence of 13 months. Patients with a LNR ≥ 0.15 were more likely to have T3/4 tumors, advanced stage lymphovascular (LVI), or perineural invasion (PNI) and develop recurrent disease. Univariate analysis demonstrated that T-stage, lymph node status, AJCC stage, LVI, PNI, and LNR were significantly associated with decreased time to distant recurrence (TTDR). In multivariate stepwise regression, only LNR and LVI were significantly associated with decreased TTDR. CONCLUSIONS: A high positive LNR is associated with distant recurrence after surgical resection of AC. Given the high risk of disease recurrence, consideration for adjuvant therapy is warranted in patients with a LNR ≥ 0.15.
BACKGROUND: For ampullary carcinoma (AC), the lymph node ratio (LNR) has been associated with overall survival. However, the use of the LNR to predict distant recurrence risk remains unknown. The purpose of this study was to determine if the LNR is associated with distant recurrence risk. METHODS: One hundred forty three patients with AC who underwent pancreaticoduodenectomy between 1989 and 2011 were identified from a single-institution prospective database. Data on clinicopathologic factors and recurrence were analyzed. RESULTS: At a median follow-up of 43 months (62 months for survivors), 55 patients (38 %) had developed recurrent disease, with a median time to recurrence of 13 months. Patients with a LNR ≥ 0.15 were more likely to have T3/4 tumors, advanced stage lymphovascular (LVI), or perineural invasion (PNI) and develop recurrent disease. Univariate analysis demonstrated that T-stage, lymph node status, AJCC stage, LVI, PNI, and LNR were significantly associated with decreased time to distant recurrence (TTDR). In multivariate stepwise regression, only LNR and LVI were significantly associated with decreased TTDR. CONCLUSIONS: A high positive LNR is associated with distant recurrence after surgical resection of AC. Given the high risk of disease recurrence, consideration for adjuvant therapy is warranted in patients with a LNR ≥ 0.15.
Authors: Jae Hoon Lee; Kyeong Geun Lee; Tae Kyung Ha; Young Jin Jun; Seung Sam Paik; Hwon Kyum Park; Kwang Soo Lee Journal: Am Surg Date: 2011-03 Impact factor: 0.688
Authors: M Tachibana; D K Dhar; S Kinugasa; T Kotoh; M Shibakita; S Ohno; R Masunaga; H Kubota; N Nagasue Journal: J Clin Gastroenterol Date: 2000-12 Impact factor: 3.062
Authors: Rosa F Hwang; Huamin Wang; Axbal Lara; Henry Gomez; Tracy Chang; Nicole Sieffert; Younghee Moon; Sabina Ram; Stuart Zimmerman; Jeffrey H Lee; Peter W T Pisters; Eric P Tamm; Jason B Fleming; James L Abbruzzese; Douglas B Evans Journal: Ann Surg Oncol Date: 2008-02-07 Impact factor: 5.344
Authors: Serdar Balci; Olca Basturk; Burcu Saka; Pelin Bagci; Lauren M Postlewait; Takuma Tajiri; Kee-Taek Jang; Nobuyuki Ohike; Grace E Kim; Alyssa Krasinskas; Hyejeong Choi; Juan M Sarmiento; David A Kooby; Bassel F El-Rayes; Jessica H Knight; Michael Goodman; Gizem Akkas; Michelle D Reid; Shishir K Maithel; Volkan Adsay Journal: Ann Surg Oncol Date: 2015-03-18 Impact factor: 5.344
Authors: S O Dima; T Dumitrascu; C Pechianu; R T Grigorie; V Brasoveanu; A Sorop; I Lupescu; R Purnichescu-Purtan; A Croitoru; N Bacalbasa; A Tanase; D R Tomescu; V Herlea; I Popescu Journal: Acta Endocrinol (Buchar) Date: 2018 Jul-Sep Impact factor: 0.877
Authors: Leonardo S Lino-Silva; Miguel A Gómez-Álvarez; Rosa A Salcedo-Hernández; Alejandro E Padilla-Rosciano; Horacio N López-Basave Journal: J Gastrointest Oncol Date: 2018-12