BACKGROUND: Some suggest that metastatic lymph node ratio (LNR) may be prognostic of survival in patients with pancreatic cancer. However, this phenomenon was confused by inclusion of node-negative patients in the analysis. The present study was designed to evaluate the prognostic impact of metastatic LNR and the absolute number of metastatic LNs in patients resected for pancreatic cancer. METHODS: Data were collected from 398 patients who underwent curative surgery for pancreatic head cancer at Seoul National University Hospital. Long-term survival was analyzed according to LNR and absolute number of metastatic LNs. RESULTS: Of the patients, 227 (57.0 %) had LN metastasis. The mean numbers of total retrieved and metastatic LNs were 19.5 and 1.9, respectively, and the mean LNR was 0.11. Median overall survival (OS) of patients was significantly higher in N0 than in N1 patients after curative resection (25.4 vs. 14.8 months, p < 0.001). Median OS was significantly lower in patients with 1 than in those with 0 positive LNs (17.3 vs. 25.4 months, p = 0.001). Among N1 patients, those with 0 < LNR ≤ 0.2 had comparable prognosis than those with >0.2 LNR (median OS 17.2 vs. 12.8 months, p = 0.096), and the number of metastatic LNs did not correlate with median OS (p = 0.365). CONCLUSIONS: The presence of a single positive metastatic LN was associated with significantly poorer OS in patients with pancreatic cancer. When LN metastasis was present, the number of metastatic LNs and LNR had limited prognostic relevance.
BACKGROUND: Some suggest that metastatic lymph node ratio (LNR) may be prognostic of survival in patients with pancreatic cancer. However, this phenomenon was confused by inclusion of node-negative patients in the analysis. The present study was designed to evaluate the prognostic impact of metastatic LNR and the absolute number of metastatic LNs in patients resected for pancreatic cancer. METHODS: Data were collected from 398 patients who underwent curative surgery for pancreatic head cancer at Seoul National University Hospital. Long-term survival was analyzed according to LNR and absolute number of metastatic LNs. RESULTS: Of the patients, 227 (57.0 %) had LN metastasis. The mean numbers of total retrieved and metastatic LNs were 19.5 and 1.9, respectively, and the mean LNR was 0.11. Median overall survival (OS) of patients was significantly higher in N0 than in N1 patients after curative resection (25.4 vs. 14.8 months, p < 0.001). Median OS was significantly lower in patients with 1 than in those with 0 positive LNs (17.3 vs. 25.4 months, p = 0.001). Among N1 patients, those with 0 < LNR ≤ 0.2 had comparable prognosis than those with >0.2 LNR (median OS 17.2 vs. 12.8 months, p = 0.096), and the number of metastatic LNs did not correlate with median OS (p = 0.365). CONCLUSIONS: The presence of a single positive metastatic LN was associated with significantly poorer OS in patients with pancreatic cancer. When LN metastasis was present, the number of metastatic LNs and LNR had limited prognostic relevance.
Authors: Toshiro Masuda; Amanda M Dann; Irmina A Elliott; Hideo Baba; Stephen Kim; Alireza Sedarat; V Raman Muthusamy; Mark D Girgis; O Joe Hines; Howard A Reber; Timothy R Donahue Journal: J Gastrointest Surg Date: 2017-10-17 Impact factor: 3.452
Authors: Moh'd Khushman; Girijesh Kumar Patel; Javier Ariel Laurini; Arun Bhardwaj; Kelly Roveda; Robert Donnell; Kelley Sherling; Brittany Case; Arthur E Frankel; Sachin Pai; William Taylor; Marcus Chuan Beng Tan; Meir Mizrahi; Cindy Nelson; Mary Wyatt; Mary Patton; Steven McClellan; Seema Singh; Bin Wang; Ajay P Singh Journal: J Gastrointest Oncol Date: 2019-08
Authors: Ajay A Patel; Sairaman Nagarajan; Eli D Scher; Caitlin Ab Schonewolf; Sairam Balasubramanian; Elizabeth Poplin; Rebecca Moss; David August; Darren Carpizo; Laleh Melstrom; Salma K Jabbour Journal: Pancreat Disord Ther Date: 2015-04-02