TY - JOUR
T1 - Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma
AU - Fukuda, Yasunari
AU - Asaoka, Tadafumi
AU - Maeda, Sakae
AU - Hama, Naoki
AU - Miyamoto, Atsushi
AU - Mori, Masaki
AU - Doki, Yuichiro
AU - Nakamori, Shoji
N1 - Publisher Copyright:
© 2017 IAP and EPC
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background The present study aimed to clarify the prognostic impact of nodal statuses in pancreatic ductal adenocarcinoma (PDAC) after potentially curative pancreatectomy. Methods In 110 patients with >10 examined lymph nodes (ELNs), we investigated how nodal statuses were associated with postoperative survival. Nodal statuses included the number of positive LNs (PLNs); the ratio of PLNs to ELNs (lymph node ratio; LNR); and the location of regional LN metastases, classified as group one (peripancreatic area) and group 2 (outside the peripancreatic area). The maximum χ2 value, provided by a Cox proportional hazards model, was used to determine the optimal cutoff value for the number of PLNs and the LNR. Results The median numbers of ELNs and metastatic LNs were 33 and 2, respectively. Median survival was longer in patients with ≤3 PLNs (37.5 months), LNR <0.11 (36.1 months), and group 1 LN metastases (37.5 months) compared to in patients with ≥4 PLNs (23.7 months), LNR ≥0.11 (23.9 months), and group 2 LN metastases (22.8 months), respectively. Multivariate analyses revealed that all three investigated nodal statuses were independent factors associated with survival: HR of 2.38 and p = 0.0006 for the location of LN metastases, HR of 1.92 and p = 0.0071 for the number of PLNs, and HR of 1.89 and p = 0.010 for the LNR. Conclusions Three nodal statuses—the number of PLNs, the LNR, and the location of LN metastases—could stratify postoperative survival among PDAC patients with an adequate number of examined LNs after pancreatectomy.
AB - Background The present study aimed to clarify the prognostic impact of nodal statuses in pancreatic ductal adenocarcinoma (PDAC) after potentially curative pancreatectomy. Methods In 110 patients with >10 examined lymph nodes (ELNs), we investigated how nodal statuses were associated with postoperative survival. Nodal statuses included the number of positive LNs (PLNs); the ratio of PLNs to ELNs (lymph node ratio; LNR); and the location of regional LN metastases, classified as group one (peripancreatic area) and group 2 (outside the peripancreatic area). The maximum χ2 value, provided by a Cox proportional hazards model, was used to determine the optimal cutoff value for the number of PLNs and the LNR. Results The median numbers of ELNs and metastatic LNs were 33 and 2, respectively. Median survival was longer in patients with ≤3 PLNs (37.5 months), LNR <0.11 (36.1 months), and group 1 LN metastases (37.5 months) compared to in patients with ≥4 PLNs (23.7 months), LNR ≥0.11 (23.9 months), and group 2 LN metastases (22.8 months), respectively. Multivariate analyses revealed that all three investigated nodal statuses were independent factors associated with survival: HR of 2.38 and p = 0.0006 for the location of LN metastases, HR of 1.92 and p = 0.0071 for the number of PLNs, and HR of 1.89 and p = 0.010 for the LNR. Conclusions Three nodal statuses—the number of PLNs, the LNR, and the location of LN metastases—could stratify postoperative survival among PDAC patients with an adequate number of examined LNs after pancreatectomy.
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U2 - 10.1016/j.pan.2017.01.003
DO - 10.1016/j.pan.2017.01.003
M3 - Article
C2 - 28122676
AN - SCOPUS:85009921565
SN - 1424-3903
VL - 17
SP - 279
EP - 284
JO - Pancreatology
JF - Pancreatology
IS - 2
ER -
