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. 2020 Aug;11(4):644-653.
doi: 10.21037/jgo-20-158.

Impact of examined lymph node count on prognosis in patients with lymph node-negative pancreatic body/tail ductal adenocarcinoma

Yu-Feng Li  1   2 , Yu-Cheng Xiang  1   2 , Qiu-Qiang Zhang  1   2 , Wei-Lin Wang  1   2   3   4
Affiliations

Impact of examined lymph node count on prognosis in patients with lymph node-negative pancreatic body/tail ductal adenocarcinoma

Yu-Feng Li et al. J Gastrointest Oncol. 2020 Aug.

Abstract

Background: Because the overall prognosis remains dismal for patients with resected pancreatic cancer (PC), we aimed to explore the prognostic impact of examined lymph node (ELN) count on lymph node (LN)-negative pancreatic body/tail ductal adenocarcinoma.

Methods: Patients' data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (National Cancer Institute, USA) to investigate the relationship between ELN count and survival outcomes of LN-negative pancreatic body/tail ductal adenocarcinoma.

Results: A total of 700 patients were included, and the median number of ELNs was 11. The respective 1-, 3-, 5-year overall survival (OS) rates were 75.3%, 37.7%, 30.3%, and the 1-, 3-, 5-year cancer-specific survival (CSS) were 78.3%, 41.7%, 34.5%. The X-tile analysis showed that 14 was the most optimal cutoff for both OS and CSS. Kaplan-Meier survival analysis indicated that patients with ELNs >14 had better OS and CSS than ELNs ≤14. Multivariate Cox analysis showed ELNs ≤14 was an independent risk factor for both OS [hazard ratio (HR), 1.357; 95% confidence interval (CI), 1.080-1.704; P=0.009] and CSS (HR, 1.394; 95% CI, 1.092-1.778; P=0.008).

Conclusions: ELN count is associated with the survival rate in patients with LN-negative pancreatic body/tail ductal adenocarcinoma. Accurate nodal staging for these patients requires more than 14 ELNs.

Keywords: Lymph nodes (LNs); Surveillance, Epidemiology, and End Results database (SEER database); pancreatic cancer (PC); prognosis.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jgo-20-158). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Distribution of ELNs in the entire cohort of patients with pancreatic body/tail ductal adenocarcinoma. ELN, examined lymph node.
Figure 2
Figure 2
Kaplan-Meier curves of survival in patients with pancreatic body/tail ductal adenocarcinoma. (A) OS; (B) CSS. OS, overall survival; CSS, cancer-specific survival.
Figure 3
Figure 3
Kaplan-Meier curves of survival in patients with pancreatic body/tail ductal adenocarcinoma according to ELN count. (A) OS; (B) CSS. OS, overall survival; CSS, cancer-specific survival; ELN, examined lymph node.
Figure S1
Figure S1
X-tile analysis of survival data in patients with pancreatic body/tail ductal adenocarcinoma according to ELN count. (A) OS; (B) CSS. OS, overall survival; CSS, cancer-specific survival; ELN, examined lymph node.
See this image and copyright information in PMC

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