A Novel Criterion for Lymph Nodes Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the US SEER Database
Objective The aim of this study was to clarify the minimum number of examined lymph nodes (MNELNs) required to ensure the quality of lymph node detection and its impact on long-term survival in distal pancreatectomy for pancreatic ductal adenocarcinoma. Methods Clinicopathological characteristics an...
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| Veröffentlicht in: | Annals of surgical oncology 2022-03, Vol.29 (3), p.1533-1539 |
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| container_title | Annals of surgical oncology |
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| creator | Wang, Weishen Shen, Ziyun Zhang, Jun Chen, Hao Deng, Xiaxing Peng, Chenghong Xie, Junjie Xu, Zhiwei Shen, Baiyong |
| description | Objective
The aim of this study was to clarify the minimum number of examined lymph nodes (MNELNs) required to ensure the quality of lymph node detection and its impact on long-term survival in distal pancreatectomy for pancreatic ductal adenocarcinoma.
Methods
Clinicopathological characteristics and survival data of patients with resectable pancreatic cancer who underwent distal pancreatectomy between 2004 and 2017 were collected from the Surveillance, Epidemiology, and End Results database. The associations between the number of examined lymph nodes (ELNs) and number of positive lymph nodes (PLNs), stage migration, and overall survival were investigated through adjusted multivariate models with locally weighted scatterplot smoothing smoothing fitting curves and estimation of the structural breakpoints. Kaplan–Meier survival analysis and X-tile software were used to identify the ideal cut-off value for ELNs.
Results
In total, 2610 consecutive patients who underwent distal pancreatectomy between 2004 and 2017 were included in this study. The optimal ELN count according to the associations between the number of ELNs and number of PLNs, odds ratio for stage migration, or hazard ratio for overall survival were 19, 17, and 19, respectively. Furthermore, the optimal division of ELN count for maximum overall survival was divided into three populations (ELN ≤ 8, ELN 9–18, ELN ≥ 19) based on X-tile software.
Conclusion
A minimal count of 19 lymph nodes was demanded to guarantee the quality of lymph node examination in patients with distal pancreatectomy. Long-term survival could be delimited by MNELNs. A sufficient number of ELNs could improve the accuracy of cancer staging and reflect a better overall survival. |
| doi_str_mv | 10.1245/s10434-021-10797-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2580696548</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2624800926</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-6ecd1affaf2a9748e001808d5b48845bfe1367b100cddf708de863e5c980a10e3</originalsourceid><addsrcrecordid>eNp9kctuEzEYhS1ERUvhBVggS2zYDPV9POyiJFykCCpC15bH85tONTMOtgcpz8BL4ySllViw8uU75_hyEHpFyTvKhLxKlAguKsJoRUnd1BV7gi6oLFtCafq0zInSVcOUPEfPU7ojhNacyGfonAvFGK_ZBfq9wF_CLxjwMvYZYh8m7EPEm_24uy2kg4RXfUrg8gH102GV7YCv7eQi2FxAGPdHz2p2B7LoYArORtdPYbTv8QJfh9082GPANs_dHgeP8y3gmy3ertff8Mpm29oEL9CZt0OCl_fjJbr5sP6-_FRtvn78vFxsKsdrmSsFrqPWe-uZbWqhobxLE93JVmgtZOuBclW3lBDXdb4uBLTiIF2jiaUE-CV6e8rdxfBzhpTN2CcHw2AnCHMyTGqiGiWFLtI3_0jvwhyncjvDFBOakPK9RcVOKhdDShG82cV-tHFvKDGHqsypKlOqMseqDCum1_fRcztC92D5200R8JMgFTT9gPh49n9i_wAwd56Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2624800926</pqid></control><display><type>article</type><title>A Novel Criterion for Lymph Nodes Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the US SEER Database</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wang, Weishen ; Shen, Ziyun ; Zhang, Jun ; Chen, Hao ; Deng, Xiaxing ; Peng, Chenghong ; Xie, Junjie ; Xu, Zhiwei ; Shen, Baiyong</creator><creatorcontrib>Wang, Weishen ; Shen, Ziyun ; Zhang, Jun ; Chen, Hao ; Deng, Xiaxing ; Peng, Chenghong ; Xie, Junjie ; Xu, Zhiwei ; Shen, Baiyong</creatorcontrib><description>Objective
The aim of this study was to clarify the minimum number of examined lymph nodes (MNELNs) required to ensure the quality of lymph node detection and its impact on long-term survival in distal pancreatectomy for pancreatic ductal adenocarcinoma.
Methods
Clinicopathological characteristics and survival data of patients with resectable pancreatic cancer who underwent distal pancreatectomy between 2004 and 2017 were collected from the Surveillance, Epidemiology, and End Results database. The associations between the number of examined lymph nodes (ELNs) and number of positive lymph nodes (PLNs), stage migration, and overall survival were investigated through adjusted multivariate models with locally weighted scatterplot smoothing smoothing fitting curves and estimation of the structural breakpoints. Kaplan–Meier survival analysis and X-tile software were used to identify the ideal cut-off value for ELNs.
Results
In total, 2610 consecutive patients who underwent distal pancreatectomy between 2004 and 2017 were included in this study. The optimal ELN count according to the associations between the number of ELNs and number of PLNs, odds ratio for stage migration, or hazard ratio for overall survival were 19, 17, and 19, respectively. Furthermore, the optimal division of ELN count for maximum overall survival was divided into three populations (ELN ≤ 8, ELN 9–18, ELN ≥ 19) based on X-tile software.
Conclusion
A minimal count of 19 lymph nodes was demanded to guarantee the quality of lymph node examination in patients with distal pancreatectomy. Long-term survival could be delimited by MNELNs. A sufficient number of ELNs could improve the accuracy of cancer staging and reflect a better overall survival.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-10797-2</identifier><identifier>PMID: 34622372</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adenocarcinoma ; Breakpoints ; Breast Neoplasms ; Cancer ; Carcinoma, Pancreatic Ductal - pathology ; Carcinoma, Pancreatic Ductal - surgery ; Computer programs ; Dissection ; Epidemiology ; Female ; Humans ; Lymph Node Excision ; Lymph nodes ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic Metastasis ; Lymphatic system ; Medicine ; Medicine & Public Health ; Neoplasm Staging ; Oncology ; Pancreatectomy ; Pancreatic cancer ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Pancreatic Tumors ; Population studies ; Population-based studies ; Prognosis ; SEER Program ; Surgery ; Surgical Oncology ; Survival ; Survival analysis</subject><ispartof>Annals of surgical oncology, 2022-03, Vol.29 (3), p.1533-1539</ispartof><rights>Society of Surgical Oncology 2021</rights><rights>2021. Society of Surgical Oncology.</rights><rights>Society of Surgical Oncology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-6ecd1affaf2a9748e001808d5b48845bfe1367b100cddf708de863e5c980a10e3</citedby><cites>FETCH-LOGICAL-c375t-6ecd1affaf2a9748e001808d5b48845bfe1367b100cddf708de863e5c980a10e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-10797-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-10797-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34622372$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Weishen</creatorcontrib><creatorcontrib>Shen, Ziyun</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Chen, Hao</creatorcontrib><creatorcontrib>Deng, Xiaxing</creatorcontrib><creatorcontrib>Peng, Chenghong</creatorcontrib><creatorcontrib>Xie, Junjie</creatorcontrib><creatorcontrib>Xu, Zhiwei</creatorcontrib><creatorcontrib>Shen, Baiyong</creatorcontrib><title>A Novel Criterion for Lymph Nodes Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the US SEER Database</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Objective
The aim of this study was to clarify the minimum number of examined lymph nodes (MNELNs) required to ensure the quality of lymph node detection and its impact on long-term survival in distal pancreatectomy for pancreatic ductal adenocarcinoma.
Methods
Clinicopathological characteristics and survival data of patients with resectable pancreatic cancer who underwent distal pancreatectomy between 2004 and 2017 were collected from the Surveillance, Epidemiology, and End Results database. The associations between the number of examined lymph nodes (ELNs) and number of positive lymph nodes (PLNs), stage migration, and overall survival were investigated through adjusted multivariate models with locally weighted scatterplot smoothing smoothing fitting curves and estimation of the structural breakpoints. Kaplan–Meier survival analysis and X-tile software were used to identify the ideal cut-off value for ELNs.
Results
In total, 2610 consecutive patients who underwent distal pancreatectomy between 2004 and 2017 were included in this study. The optimal ELN count according to the associations between the number of ELNs and number of PLNs, odds ratio for stage migration, or hazard ratio for overall survival were 19, 17, and 19, respectively. Furthermore, the optimal division of ELN count for maximum overall survival was divided into three populations (ELN ≤ 8, ELN 9–18, ELN ≥ 19) based on X-tile software.
Conclusion
A minimal count of 19 lymph nodes was demanded to guarantee the quality of lymph node examination in patients with distal pancreatectomy. Long-term survival could be delimited by MNELNs. A sufficient number of ELNs could improve the accuracy of cancer staging and reflect a better overall survival.</description><subject>Adenocarcinoma</subject><subject>Breakpoints</subject><subject>Breast Neoplasms</subject><subject>Cancer</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Computer programs</subject><subject>Dissection</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreatic Tumors</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prognosis</subject><subject>SEER Program</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Survival analysis</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctuEzEYhS1ERUvhBVggS2zYDPV9POyiJFykCCpC15bH85tONTMOtgcpz8BL4ySllViw8uU75_hyEHpFyTvKhLxKlAguKsJoRUnd1BV7gi6oLFtCafq0zInSVcOUPEfPU7ojhNacyGfonAvFGK_ZBfq9wF_CLxjwMvYZYh8m7EPEm_24uy2kg4RXfUrg8gH102GV7YCv7eQi2FxAGPdHz2p2B7LoYArORtdPYbTv8QJfh9082GPANs_dHgeP8y3gmy3ertff8Mpm29oEL9CZt0OCl_fjJbr5sP6-_FRtvn78vFxsKsdrmSsFrqPWe-uZbWqhobxLE93JVmgtZOuBclW3lBDXdb4uBLTiIF2jiaUE-CV6e8rdxfBzhpTN2CcHw2AnCHMyTGqiGiWFLtI3_0jvwhyncjvDFBOakPK9RcVOKhdDShG82cV-tHFvKDGHqsypKlOqMseqDCum1_fRcztC92D5200R8JMgFTT9gPh49n9i_wAwd56Q</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Wang, Weishen</creator><creator>Shen, Ziyun</creator><creator>Zhang, Jun</creator><creator>Chen, Hao</creator><creator>Deng, Xiaxing</creator><creator>Peng, Chenghong</creator><creator>Xie, Junjie</creator><creator>Xu, Zhiwei</creator><creator>Shen, Baiyong</creator><general>Springer International Publishing</general><general>Springer Nature B.V</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>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20220301</creationdate><title>A Novel Criterion for Lymph Nodes Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the US SEER Database</title><author>Wang, Weishen ; Shen, Ziyun ; Zhang, Jun ; Chen, Hao ; Deng, Xiaxing ; Peng, Chenghong ; Xie, Junjie ; Xu, Zhiwei ; Shen, Baiyong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-6ecd1affaf2a9748e001808d5b48845bfe1367b100cddf708de863e5c980a10e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adenocarcinoma</topic><topic>Breakpoints</topic><topic>Breast Neoplasms</topic><topic>Cancer</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Computer programs</topic><topic>Dissection</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Pancreatic Tumors</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prognosis</topic><topic>SEER Program</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Survival analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Weishen</creatorcontrib><creatorcontrib>Shen, Ziyun</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Chen, Hao</creatorcontrib><creatorcontrib>Deng, Xiaxing</creatorcontrib><creatorcontrib>Peng, Chenghong</creatorcontrib><creatorcontrib>Xie, Junjie</creatorcontrib><creatorcontrib>Xu, Zhiwei</creatorcontrib><creatorcontrib>Shen, Baiyong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Weishen</au><au>Shen, Ziyun</au><au>Zhang, Jun</au><au>Chen, Hao</au><au>Deng, Xiaxing</au><au>Peng, Chenghong</au><au>Xie, Junjie</au><au>Xu, Zhiwei</au><au>Shen, Baiyong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Novel Criterion for Lymph Nodes Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the US SEER Database</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>29</volume><issue>3</issue><spage>1533</spage><epage>1539</epage><pages>1533-1539</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Objective
The aim of this study was to clarify the minimum number of examined lymph nodes (MNELNs) required to ensure the quality of lymph node detection and its impact on long-term survival in distal pancreatectomy for pancreatic ductal adenocarcinoma.
Methods
Clinicopathological characteristics and survival data of patients with resectable pancreatic cancer who underwent distal pancreatectomy between 2004 and 2017 were collected from the Surveillance, Epidemiology, and End Results database. The associations between the number of examined lymph nodes (ELNs) and number of positive lymph nodes (PLNs), stage migration, and overall survival were investigated through adjusted multivariate models with locally weighted scatterplot smoothing smoothing fitting curves and estimation of the structural breakpoints. Kaplan–Meier survival analysis and X-tile software were used to identify the ideal cut-off value for ELNs.
Results
In total, 2610 consecutive patients who underwent distal pancreatectomy between 2004 and 2017 were included in this study. The optimal ELN count according to the associations between the number of ELNs and number of PLNs, odds ratio for stage migration, or hazard ratio for overall survival were 19, 17, and 19, respectively. Furthermore, the optimal division of ELN count for maximum overall survival was divided into three populations (ELN ≤ 8, ELN 9–18, ELN ≥ 19) based on X-tile software.
Conclusion
A minimal count of 19 lymph nodes was demanded to guarantee the quality of lymph node examination in patients with distal pancreatectomy. Long-term survival could be delimited by MNELNs. A sufficient number of ELNs could improve the accuracy of cancer staging and reflect a better overall survival.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34622372</pmid><doi>10.1245/s10434-021-10797-2</doi><tpages>7</tpages></addata></record> |
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| subjects | Adenocarcinoma Breakpoints Breast Neoplasms Cancer Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - surgery Computer programs Dissection Epidemiology Female Humans Lymph Node Excision Lymph nodes Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis Lymphatic system Medicine Medicine & Public Health Neoplasm Staging Oncology Pancreatectomy Pancreatic cancer Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Pancreatic Tumors Population studies Population-based studies Prognosis SEER Program Surgery Surgical Oncology Survival Survival analysis |
| title | A Novel Criterion for Lymph Nodes Dissection in Distal Pancreatectomy for Ductal Adenocarcinoma: A Population Study of the US SEER Database |
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