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. 2016 Jun;18(6):523-8.
doi: 10.1016/j.hpb.2016.02.004.

Pancreatic cancer metastatic to a limited number of lymph nodes has no impact on outcome

Scott Baldwin  1 , Moshim Kukar  2 , Emmanuel Gabriel  1 , Kristopher Attwood  3 , Neal Wilkinson  1 , Steven N Hochwald  1 , Boris Kuvshinoff  1
Affiliations

Pancreatic cancer metastatic to a limited number of lymph nodes has no impact on outcome

Scott Baldwin et al. HPB (Oxford). 2016 Jun.

Abstract

Background: The purpose of this study was to determine the association of the extent of metastatic lymph node involvement with survival in pancreatic cancer.

Methods: This is a retrospective review of a prospectively maintained database of patients who underwent resection for pancreatic adenocarcinoma, 1999-2011.

Results: 165 patients were identified and divided into 3 groups based on the number of positive lymph nodes - 0 (group A), 1-2 (B), >3 (C). Each group had 55 patients. Those in group C were more likely to have a higher T stage, poorly differentiated grade, lymphovascular invasion (LVI), higher mean intraoperative blood loss, positive margins, tumor location involving the uncinate process, and a higher likelihood of undergoing a pancreaticoduodenectomy. Median overall survival (OS) for group A, B and C was 25.5 months (mo), 21 mo and 12.3 mo, respectively (p < 0.001). No survival difference was noted for survival between groups A and B (p = 0.86). The ratio of involved lymph nodes <0.2 was predictive of improved survival (p < 0.001).

Conclusions: Resected pancreatic cancer patients with only 1-2 positive lymph nodes or less than 20% involvement have a similar prognosis to patients without nodal disease. Current staging should consider stratification based on the extent of nodal involvement.

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Figures

Figure 1
Figure 1
Recurrence-free survival (RFS) and overall survival (OS) stratified by the number of positive lymph nodes. Groups include 0, 1–2, and 3 or more positive lymph nodes. RFS is shown in the left panel, OS in the right
Figure 2
Figure 2
Recurrence-free survival (RFS) and overall survival (OS) stratified by the number of lymph nodes resected and examined. Groups include 5 or less, 6–10 and greater than 10 lymph nodes examined. RFS is shown in the left panel, OS in the right
Figure 3
Figure 3
Recurrence-free survival (RFS) and overall survival (OS) by ratio of positive lymph nodes to total nodes examined. Groups include ratios of 0, 0–0.2, 0.2–0.4 and greater than 0.4. RFS is shown in the left panel, OS in the right
See this image and copyright information in PMC

References

    1. Fortner J.G. Regional resection of cancer of the pancreas: a new surgical approach. Surgery (USA) 1973;73:307–320. - PubMed
    1. Pedrazzoli S., DiCarlo V., Dionigi R., Mosca F., Pederzoli P., Pasquali C. Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a multicenter, prospective, randomized study. Ann Surg. 1998;228:508–517. - PMC - PubMed
    1. Winter J.M., Cameron J.L., Campbell K.A., Arnold M.A., Chang D.C., Coleman J. 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg. 2006;10:1199–1211. - PubMed
    1. Allema J.H., Reinders M.E., Van Gulik T.M., Koelemay M.J.W., Van Leeuwen D.J., De Wit L.T. Prognostic factors for survival after pancreaticoduodenectomy for patients with carcinoma of the pancreatic head region. Cancer. 1995;75:2069–2076. - PubMed
    1. Lim J.E., Chien M.W., Earle C.C. Prognostic factors following curative resection for pancreatic adenocarcinoma: a population-based, linked database analysis of 396 patients. Ann Surg. 2003;237:74–85. - PMC - PubMed

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