Neoadjuvant Therapy is Associated with a Reduced Lymph Node Ratio in Patients with Potentially Resectable Pancreatic Cancer
Background The use of neoadjuvant therapy (NAC) for the treatment of potentially resectable pancreatic cancer remains controversial. In this study, we sought to evaluate cancer-specific endpoints in patients undergoing a NAC versus a surgery-first (SF) approach with specific emphasis on lymph node m...
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| Veröffentlicht in: | Annals of surgical oncology 2015-04, Vol.22 (4), p.1168-1175 |
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| creator | Roland, Christina L. Yang, Anthony D. Katz, Matthew H. G. Chatterjee, Deyali Wang, Huamin Lin, Heather Vauthey, Jean N. Pisters, Peter W. Varadhachary, Gauri R. Wolff, Robert A. Crane, Christopher H. Lee, Jeffrey E. Fleming, Jason B. |
| description | Background
The use of neoadjuvant therapy (NAC) for the treatment of potentially resectable pancreatic cancer remains controversial. In this study, we sought to evaluate cancer-specific endpoints in patients undergoing a NAC versus a surgery-first (SF) approach with specific emphasis on lymph node metastases.
Methods
A total of 222 patients who underwent NAC and 85 patients who underwent SF were identified from 1990 to 2008 and compared for cancer-related endpoints. Peripancreatic lymph nodes from 135 neoadjuvant therapy patients were evaluated for histologic tumor regression.
Results
Patients who underwent NAC followed by surgery had improved overall survival and time to local recurrence compared with the SF approach. NAC patients were less likely to have lymph node metastases (
p
= 0.001), lymphovascular invasion (LVI), and had smaller tumors. On multivariate analysis, lymph node positivity was associated with SF, tumor size, and the presence of LVI. NAC patients with N0 disease had equivalent outcomes to patients with a low-LNR (0.01–0.15), whereas patients with a LNR >0.15 had reduced survival, and time to local and distant recurrence. Ten of 135 (7.4 %) NAC patients had evidence of tumor regression in at least one lymph node.
Conclusions
Patients with potentially resectable PDAC selected to undergo NAC had improved survival and longer time to recurrence. Although some of these differences may be related to improvements in multimodality therapy completion rates, tumor regression in lymph node metastases exists and may demonstrate a biologic benefit of NAC compared with a SF approach. |
| doi_str_mv | 10.1245/s10434-014-4192-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5131370</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3609169911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-84e51ad7b111ae549e9b1f94808f3d1b03c130bcb5e21682135dad39a0049f13</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhoMo7rr6A7xIwIuX1lS-uvsiLINfMKzLMveQTqp3MvR0xqR7ZfDPm6HXZRU8pSr11FtVvIS8BvYeuFQfMjApZMVAVhJaXukn5BxU-ZG6gaclZrqpWq7VGXmR844xqAVTz8kZV0Jxrutz8usKo_W7-c6OE91sMdnDkYZML3OOLtgJPf0Zpi219Ab97Eq6Pu4PW3oVPdIbO4VIw0ivS4DjlBf2Ok4lCXYYjqUro5tsN2CBRpewkI6uSojpJXnW2yHjq_v3gmw-f9qsvlbr71--rS7XlVOSTVUjUYH1dQcAFpVsse2gb2XDml546JhwIFjnOoUcdMNBKG-9aC1jsu1BXJCPi-xh7vboXdkt2cEcUtjbdDTRBvN3ZQxbcxvvjAIBomZF4N29QIo_ZsyT2YfscBjsiHHOBrRmkoOq64K-_QfdxTmN5bpCqaYFJfWJgoVyKeacsH9YBpg5OWsWZ01x1pycNbr0vHl8xUPHHysLwBcgl9J4i-nR6P-q_gaULq-o</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1658915467</pqid></control><display><type>article</type><title>Neoadjuvant Therapy is Associated with a Reduced Lymph Node Ratio in Patients with Potentially Resectable Pancreatic Cancer</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Roland, Christina L. ; Yang, Anthony D. ; Katz, Matthew H. G. ; Chatterjee, Deyali ; Wang, Huamin ; Lin, Heather ; Vauthey, Jean N. ; Pisters, Peter W. ; Varadhachary, Gauri R. ; Wolff, Robert A. ; Crane, Christopher H. ; Lee, Jeffrey E. ; Fleming, Jason B.</creator><creatorcontrib>Roland, Christina L. ; Yang, Anthony D. ; Katz, Matthew H. G. ; Chatterjee, Deyali ; Wang, Huamin ; Lin, Heather ; Vauthey, Jean N. ; Pisters, Peter W. ; Varadhachary, Gauri R. ; Wolff, Robert A. ; Crane, Christopher H. ; Lee, Jeffrey E. ; Fleming, Jason B.</creatorcontrib><description>Background
The use of neoadjuvant therapy (NAC) for the treatment of potentially resectable pancreatic cancer remains controversial. In this study, we sought to evaluate cancer-specific endpoints in patients undergoing a NAC versus a surgery-first (SF) approach with specific emphasis on lymph node metastases.
Methods
A total of 222 patients who underwent NAC and 85 patients who underwent SF were identified from 1990 to 2008 and compared for cancer-related endpoints. Peripancreatic lymph nodes from 135 neoadjuvant therapy patients were evaluated for histologic tumor regression.
Results
Patients who underwent NAC followed by surgery had improved overall survival and time to local recurrence compared with the SF approach. NAC patients were less likely to have lymph node metastases (
p
= 0.001), lymphovascular invasion (LVI), and had smaller tumors. On multivariate analysis, lymph node positivity was associated with SF, tumor size, and the presence of LVI. NAC patients with N0 disease had equivalent outcomes to patients with a low-LNR (0.01–0.15), whereas patients with a LNR >0.15 had reduced survival, and time to local and distant recurrence. Ten of 135 (7.4 %) NAC patients had evidence of tumor regression in at least one lymph node.
Conclusions
Patients with potentially resectable PDAC selected to undergo NAC had improved survival and longer time to recurrence. Although some of these differences may be related to improvements in multimodality therapy completion rates, tumor regression in lymph node metastases exists and may demonstrate a biologic benefit of NAC compared with a SF approach.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-014-4192-6</identifier><identifier>PMID: 25352267</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - secondary ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Pancreatic Ductal - mortality ; Carcinoma, Pancreatic Ductal - secondary ; Carcinoma, Pancreatic Ductal - therapy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - therapy ; Neoplasm Staging ; Oncology ; Pancreatectomy ; Pancreatic cancer ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - therapy ; Pancreatic Tumors ; Prognosis ; Surgery ; Surgical Oncology ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2015-04, Vol.22 (4), p.1168-1175</ispartof><rights>Society of Surgical Oncology 2014</rights><rights>Society of Surgical Oncology 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-84e51ad7b111ae549e9b1f94808f3d1b03c130bcb5e21682135dad39a0049f13</citedby><cites>FETCH-LOGICAL-c540t-84e51ad7b111ae549e9b1f94808f3d1b03c130bcb5e21682135dad39a0049f13</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/s10434-014-4192-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-014-4192-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25352267$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roland, Christina L.</creatorcontrib><creatorcontrib>Yang, Anthony D.</creatorcontrib><creatorcontrib>Katz, Matthew H. G.</creatorcontrib><creatorcontrib>Chatterjee, Deyali</creatorcontrib><creatorcontrib>Wang, Huamin</creatorcontrib><creatorcontrib>Lin, Heather</creatorcontrib><creatorcontrib>Vauthey, Jean N.</creatorcontrib><creatorcontrib>Pisters, Peter W.</creatorcontrib><creatorcontrib>Varadhachary, Gauri R.</creatorcontrib><creatorcontrib>Wolff, Robert A.</creatorcontrib><creatorcontrib>Crane, Christopher H.</creatorcontrib><creatorcontrib>Lee, Jeffrey E.</creatorcontrib><creatorcontrib>Fleming, Jason B.</creatorcontrib><title>Neoadjuvant Therapy is Associated with a Reduced Lymph Node Ratio in Patients with Potentially Resectable Pancreatic Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
The use of neoadjuvant therapy (NAC) for the treatment of potentially resectable pancreatic cancer remains controversial. In this study, we sought to evaluate cancer-specific endpoints in patients undergoing a NAC versus a surgery-first (SF) approach with specific emphasis on lymph node metastases.
Methods
A total of 222 patients who underwent NAC and 85 patients who underwent SF were identified from 1990 to 2008 and compared for cancer-related endpoints. Peripancreatic lymph nodes from 135 neoadjuvant therapy patients were evaluated for histologic tumor regression.
Results
Patients who underwent NAC followed by surgery had improved overall survival and time to local recurrence compared with the SF approach. NAC patients were less likely to have lymph node metastases (
p
= 0.001), lymphovascular invasion (LVI), and had smaller tumors. On multivariate analysis, lymph node positivity was associated with SF, tumor size, and the presence of LVI. NAC patients with N0 disease had equivalent outcomes to patients with a low-LNR (0.01–0.15), whereas patients with a LNR >0.15 had reduced survival, and time to local and distant recurrence. Ten of 135 (7.4 %) NAC patients had evidence of tumor regression in at least one lymph node.
Conclusions
Patients with potentially resectable PDAC selected to undergo NAC had improved survival and longer time to recurrence. Although some of these differences may be related to improvements in multimodality therapy completion rates, tumor regression in lymph node metastases exists and may demonstrate a biologic benefit of NAC compared with a SF approach.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - secondary</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Carcinoma, Pancreatic Ductal - mortality</subject><subject>Carcinoma, Pancreatic Ductal - secondary</subject><subject>Carcinoma, Pancreatic Ductal - therapy</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - therapy</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Pancreatic Tumors</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU2LFDEQhoMo7rr6A7xIwIuX1lS-uvsiLINfMKzLMveQTqp3MvR0xqR7ZfDPm6HXZRU8pSr11FtVvIS8BvYeuFQfMjApZMVAVhJaXukn5BxU-ZG6gaclZrqpWq7VGXmR844xqAVTz8kZV0Jxrutz8usKo_W7-c6OE91sMdnDkYZML3OOLtgJPf0Zpi219Ab97Eq6Pu4PW3oVPdIbO4VIw0ivS4DjlBf2Ok4lCXYYjqUro5tsN2CBRpewkI6uSojpJXnW2yHjq_v3gmw-f9qsvlbr71--rS7XlVOSTVUjUYH1dQcAFpVsse2gb2XDml546JhwIFjnOoUcdMNBKG-9aC1jsu1BXJCPi-xh7vboXdkt2cEcUtjbdDTRBvN3ZQxbcxvvjAIBomZF4N29QIo_ZsyT2YfscBjsiHHOBrRmkoOq64K-_QfdxTmN5bpCqaYFJfWJgoVyKeacsH9YBpg5OWsWZ01x1pycNbr0vHl8xUPHHysLwBcgl9J4i-nR6P-q_gaULq-o</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Roland, Christina L.</creator><creator>Yang, Anthony D.</creator><creator>Katz, Matthew H. G.</creator><creator>Chatterjee, Deyali</creator><creator>Wang, Huamin</creator><creator>Lin, Heather</creator><creator>Vauthey, Jean N.</creator><creator>Pisters, Peter W.</creator><creator>Varadhachary, Gauri R.</creator><creator>Wolff, Robert A.</creator><creator>Crane, Christopher H.</creator><creator>Lee, Jeffrey E.</creator><creator>Fleming, Jason B.</creator><general>Springer US</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150401</creationdate><title>Neoadjuvant Therapy is Associated with a Reduced Lymph Node Ratio in Patients with Potentially Resectable Pancreatic Cancer</title><author>Roland, Christina L. ; Yang, Anthony D. ; Katz, Matthew H. G. ; Chatterjee, Deyali ; Wang, Huamin ; Lin, Heather ; Vauthey, Jean N. ; Pisters, Peter W. ; Varadhachary, Gauri R. ; Wolff, Robert A. ; Crane, Christopher H. ; Lee, Jeffrey E. ; Fleming, Jason B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-84e51ad7b111ae549e9b1f94808f3d1b03c130bcb5e21682135dad39a0049f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - secondary</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Carcinoma, Pancreatic Ductal - mortality</topic><topic>Carcinoma, Pancreatic Ductal - secondary</topic><topic>Carcinoma, Pancreatic Ductal - therapy</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - therapy</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - therapy</topic><topic>Pancreatic Tumors</topic><topic>Prognosis</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roland, Christina L.</creatorcontrib><creatorcontrib>Yang, Anthony D.</creatorcontrib><creatorcontrib>Katz, Matthew H. G.</creatorcontrib><creatorcontrib>Chatterjee, Deyali</creatorcontrib><creatorcontrib>Wang, Huamin</creatorcontrib><creatorcontrib>Lin, Heather</creatorcontrib><creatorcontrib>Vauthey, Jean N.</creatorcontrib><creatorcontrib>Pisters, Peter W.</creatorcontrib><creatorcontrib>Varadhachary, Gauri R.</creatorcontrib><creatorcontrib>Wolff, Robert A.</creatorcontrib><creatorcontrib>Crane, Christopher H.</creatorcontrib><creatorcontrib>Lee, Jeffrey E.</creatorcontrib><creatorcontrib>Fleming, Jason B.</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>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roland, Christina L.</au><au>Yang, Anthony D.</au><au>Katz, Matthew H. G.</au><au>Chatterjee, Deyali</au><au>Wang, Huamin</au><au>Lin, Heather</au><au>Vauthey, Jean N.</au><au>Pisters, Peter W.</au><au>Varadhachary, Gauri R.</au><au>Wolff, Robert A.</au><au>Crane, Christopher H.</au><au>Lee, Jeffrey E.</au><au>Fleming, Jason B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neoadjuvant Therapy is Associated with a Reduced Lymph Node Ratio in Patients with Potentially Resectable Pancreatic Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>22</volume><issue>4</issue><spage>1168</spage><epage>1175</epage><pages>1168-1175</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
The use of neoadjuvant therapy (NAC) for the treatment of potentially resectable pancreatic cancer remains controversial. In this study, we sought to evaluate cancer-specific endpoints in patients undergoing a NAC versus a surgery-first (SF) approach with specific emphasis on lymph node metastases.
Methods
A total of 222 patients who underwent NAC and 85 patients who underwent SF were identified from 1990 to 2008 and compared for cancer-related endpoints. Peripancreatic lymph nodes from 135 neoadjuvant therapy patients were evaluated for histologic tumor regression.
Results
Patients who underwent NAC followed by surgery had improved overall survival and time to local recurrence compared with the SF approach. NAC patients were less likely to have lymph node metastases (
p
= 0.001), lymphovascular invasion (LVI), and had smaller tumors. On multivariate analysis, lymph node positivity was associated with SF, tumor size, and the presence of LVI. NAC patients with N0 disease had equivalent outcomes to patients with a low-LNR (0.01–0.15), whereas patients with a LNR >0.15 had reduced survival, and time to local and distant recurrence. Ten of 135 (7.4 %) NAC patients had evidence of tumor regression in at least one lymph node.
Conclusions
Patients with potentially resectable PDAC selected to undergo NAC had improved survival and longer time to recurrence. Although some of these differences may be related to improvements in multimodality therapy completion rates, tumor regression in lymph node metastases exists and may demonstrate a biologic benefit of NAC compared with a SF approach.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>25352267</pmid><doi>10.1245/s10434-014-4192-6</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2015-04, Vol.22 (4), p.1168-1175 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5131370 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adenocarcinoma - mortality Adenocarcinoma - secondary Adenocarcinoma - therapy Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Pancreatic Ductal - mortality Carcinoma, Pancreatic Ductal - secondary Carcinoma, Pancreatic Ductal - therapy Combined Modality Therapy Female Follow-Up Studies Humans Lymph Nodes - pathology Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Neoadjuvant Therapy Neoplasm Grading Neoplasm Invasiveness Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - therapy Neoplasm Staging Oncology Pancreatectomy Pancreatic cancer Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Pancreatic Neoplasms - therapy Pancreatic Tumors Prognosis Surgery Surgical Oncology Survival Rate |
| title | Neoadjuvant Therapy is Associated with a Reduced Lymph Node Ratio in Patients with Potentially Resectable Pancreatic Cancer |
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