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Revisiting the concept of lymph node metastases of pancreatic head cancer: number of metastatic lymph nodes and lymph node ratio according to N stage.
Ann Surg Oncol. 2014 May; 21(5):1545-51.AS

Abstract

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+Show Affiliations

Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24419758

Citation

Kang, Mee Joo, et al. "Revisiting the Concept of Lymph Node Metastases of Pancreatic Head Cancer: Number of Metastatic Lymph Nodes and Lymph Node Ratio According to N Stage." Annals of Surgical Oncology, vol. 21, no. 5, 2014, pp. 1545-51.
Kang MJ, Jang JY, Chang YR, et al. Revisiting the concept of lymph node metastases of pancreatic head cancer: number of metastatic lymph nodes and lymph node ratio according to N stage. Ann Surg Oncol. 2014;21(5):1545-51.
Kang, M. J., Jang, J. Y., Chang, Y. R., Kwon, W., Jung, W., & Kim, S. W. (2014). Revisiting the concept of lymph node metastases of pancreatic head cancer: number of metastatic lymph nodes and lymph node ratio according to N stage. Annals of Surgical Oncology, 21(5), 1545-51. https://doi.org/10.1245/s10434-013-3473-9
Kang MJ, et al. Revisiting the Concept of Lymph Node Metastases of Pancreatic Head Cancer: Number of Metastatic Lymph Nodes and Lymph Node Ratio According to N Stage. Ann Surg Oncol. 2014;21(5):1545-51. PubMed PMID: 24419758.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revisiting the concept of lymph node metastases of pancreatic head cancer: number of metastatic lymph nodes and lymph node ratio according to N stage. AU - Kang,Mee Joo, AU - Jang,Jin-Young, AU - Chang,Ye Rim, AU - Kwon,Wooil, AU - Jung,Woohyun, AU - Kim,Sun-Whe, Y1 - 2014/01/14/ PY - 2013/09/17/received PY - 2014/1/15/entrez PY - 2014/1/15/pubmed PY - 2014/12/19/medline SP - 1545 EP - 51 JF - Annals of surgical oncology JO - Ann. Surg. Oncol. VL - 21 IS - 5 N2 - 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. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/24419758/Revisiting_the_concept_of_lymph_node_metastases_of_pancreatic_head_cancer:_number_of_metastatic_lymph_nodes_and_lymph_node_ratio_according_to_N_stage_ L2 - https://dx.doi.org/10.1245/s10434-013-3473-9 DB - PRIME DP - Unbound Medicine ER -