Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma
Abstract 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 wit...
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| Veröffentlicht in: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2017-03, Vol.17 (2), p.279-284 |
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| creator | Fukuda, Yasunari Asaoka, Tadafumi Maeda, Sakae Hama, Naoki Miyamoto, Atsushi Mori, Masaki Doki, Yuichiro Nakamori, Shoji |
| description | Abstract 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 |
| doi_str_mv | 10.1016/j.pan.2017.01.003 |
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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.</description><identifier>ISSN: 1424-3903</identifier><identifier>EISSN: 1424-3911</identifier><identifier>DOI: 10.1016/j.pan.2017.01.003</identifier><identifier>PMID: 28122676</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Adenocarcinoma ; Adenocarcinoma - pathology ; Aged ; Aged, 80 and over ; Biopsy ; Chemotherapy ; Cholangiocarcinoma ; Classification ; Computed tomography ; Computer programs ; Cytology ; Death ; Endocrinology & Metabolism ; Female ; Gastric cancer ; Gastroenterology and Hepatology ; Gemcitabine ; Humans ; Inflammation ; Kidneys ; Lymph node ; Lymph nodes ; Lymph Nodes - pathology ; Lymphatic Metastasis - diagnosis ; Lymphatic Metastasis - pathology ; Lymphatic system ; Male ; Medical prognosis ; Metastases ; Metastasis ; Middle Aged ; Neoplasm Staging ; Pancreatic cancer ; Pancreatic ductal carcinoma ; Pancreatic Neoplasms - pathology ; Peritoneum ; Radiation therapy ; Spleen ; Statistics ; Studies ; Surgery ; Survival ; Survival analysis ; Tumors ; Veins & arteries</subject><ispartof>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2017-03, Vol.17 (2), p.279-284</ispartof><rights>2017 IAP and EPC</rights><rights>Copyright © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Limited Mar-Apr 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c469t-97a4091e8c2df4490aef6fdbbebab49fe247f646e8394a1af64f4ff4328bd2ec3</citedby><cites>FETCH-LOGICAL-c469t-97a4091e8c2df4490aef6fdbbebab49fe247f646e8394a1af64f4ff4328bd2ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28122676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fukuda, Yasunari</creatorcontrib><creatorcontrib>Asaoka, Tadafumi</creatorcontrib><creatorcontrib>Maeda, Sakae</creatorcontrib><creatorcontrib>Hama, Naoki</creatorcontrib><creatorcontrib>Miyamoto, Atsushi</creatorcontrib><creatorcontrib>Mori, Masaki</creatorcontrib><creatorcontrib>Doki, Yuichiro</creatorcontrib><creatorcontrib>Nakamori, Shoji</creatorcontrib><title>Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma</title><title>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</title><addtitle>Pancreatology</addtitle><description>Abstract 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.</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - pathology</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy</subject><subject>Chemotherapy</subject><subject>Cholangiocarcinoma</subject><subject>Classification</subject><subject>Computed tomography</subject><subject>Computer programs</subject><subject>Cytology</subject><subject>Death</subject><subject>Endocrinology & Metabolism</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Gastroenterology and Hepatology</subject><subject>Gemcitabine</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Kidneys</subject><subject>Lymph node</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis - diagnosis</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Pancreatic cancer</subject><subject>Pancreatic ductal carcinoma</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Peritoneum</subject><subject>Radiation therapy</subject><subject>Spleen</subject><subject>Statistics</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tumors</subject><subject>Veins & arteries</subject><issn>1424-3903</issn><issn>1424-3911</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkk-L1TAUxYsozh_9AG6k4MbNq7lJJm0QhGFwVBhQ0FmHNLnRPNukJqky396UN44wC3GVG_idA_ec2zTPgHRAQLzad4sOHSXQdwQ6QtiD5hg45TsmAR7ezYQdNSc57wmhFEA-bo7oAJSKXhw3159S_BpiLt60fl60KW10bYhWT20uuqwZc-tDu-jiMZTc_vLlW_0Fk1BvIruaUlltMUSjk_EhzvpJ88jpKePT2_e0ub58--Xi_e7q47sPF-dXO8OFLDvZa04k4GCodZxLotEJZ8cRRz1y6ZDy3gkucGCSa9B1dtw5zugwWoqGnTYvD75Lij9WzEXNPhucJh0wrlnBMEAvCBPDf6CC0uEMpKzoi3voPq4p1EU2Q06F7M_6SsGBMinmnNCpJflZpxsFRG31qL2qOamtHkVA1Xqq5vmt8zrOaO8Uf_qowOsDgDW1nx6TyqbmbtD6hKYoG_0_7d_cU5vJB2_09B1vMP_dQmWqiPq83cd2HtAzUvWE_QZOZLVA</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Fukuda, Yasunari</creator><creator>Asaoka, Tadafumi</creator><creator>Maeda, Sakae</creator><creator>Hama, Naoki</creator><creator>Miyamoto, Atsushi</creator><creator>Mori, Masaki</creator><creator>Doki, Yuichiro</creator><creator>Nakamori, Shoji</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma</title><author>Fukuda, Yasunari ; Asaoka, Tadafumi ; Maeda, Sakae ; Hama, Naoki ; Miyamoto, Atsushi ; Mori, Masaki ; Doki, Yuichiro ; Nakamori, Shoji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-97a4091e8c2df4490aef6fdbbebab49fe247f646e8394a1af64f4ff4328bd2ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - pathology</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biopsy</topic><topic>Chemotherapy</topic><topic>Cholangiocarcinoma</topic><topic>Classification</topic><topic>Computed tomography</topic><topic>Computer programs</topic><topic>Cytology</topic><topic>Death</topic><topic>Endocrinology & Metabolism</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Gastroenterology and Hepatology</topic><topic>Gemcitabine</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Kidneys</topic><topic>Lymph node</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis - diagnosis</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Pancreatic cancer</topic><topic>Pancreatic ductal carcinoma</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Peritoneum</topic><topic>Radiation therapy</topic><topic>Spleen</topic><topic>Statistics</topic><topic>Studies</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tumors</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fukuda, Yasunari</creatorcontrib><creatorcontrib>Asaoka, Tadafumi</creatorcontrib><creatorcontrib>Maeda, Sakae</creatorcontrib><creatorcontrib>Hama, Naoki</creatorcontrib><creatorcontrib>Miyamoto, Atsushi</creatorcontrib><creatorcontrib>Mori, Masaki</creatorcontrib><creatorcontrib>Doki, Yuichiro</creatorcontrib><creatorcontrib>Nakamori, Shoji</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fukuda, Yasunari</au><au>Asaoka, Tadafumi</au><au>Maeda, Sakae</au><au>Hama, Naoki</au><au>Miyamoto, Atsushi</au><au>Mori, Masaki</au><au>Doki, Yuichiro</au><au>Nakamori, Shoji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma</atitle><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle><addtitle>Pancreatology</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>17</volume><issue>2</issue><spage>279</spage><epage>284</epage><pages>279-284</pages><issn>1424-3903</issn><eissn>1424-3911</eissn><abstract>Abstract 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.</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>28122676</pmid><doi>10.1016/j.pan.2017.01.003</doi><tpages>6</tpages></addata></record> |
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| subjects | Adenocarcinoma Adenocarcinoma - pathology Aged Aged, 80 and over Biopsy Chemotherapy Cholangiocarcinoma Classification Computed tomography Computer programs Cytology Death Endocrinology & Metabolism Female Gastric cancer Gastroenterology and Hepatology Gemcitabine Humans Inflammation Kidneys Lymph node Lymph nodes Lymph Nodes - pathology Lymphatic Metastasis - diagnosis Lymphatic Metastasis - pathology Lymphatic system Male Medical prognosis Metastases Metastasis Middle Aged Neoplasm Staging Pancreatic cancer Pancreatic ductal carcinoma Pancreatic Neoplasms - pathology Peritoneum Radiation therapy Spleen Statistics Studies Surgery Survival Survival analysis Tumors Veins & arteries |
| title | Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma |
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