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. 2021 Apr;28(4):2257-2264.
doi: 10.1245/s10434-020-09543-x. Epub 2021 Jan 15.

Clinical Implication of Node-negative Resectable Pancreatic Cancer

Mihoko Yamada  1 , Teiichi Sugiura  2 , Yukiyasu Okamura  1 , Takaaki Ito  1 , Yusuke Yamamoto  1 , Ryo Ashida  1 , Katsuhisa Ohgi  1 , Takeshi Aramaki  3 , Masahiro Endo  3 , Katsuhiko Uesaka  1
Affiliations

Clinical Implication of Node-negative Resectable Pancreatic Cancer

Mihoko Yamada et al. Ann Surg Oncol. 2021 Apr.

Abstract

Background: Lymph node metastasis is one of the strongest prognostic factors of pancreatic cancer. However, the clinical implication of pathologically node-negative pancreatic cancer (pN0-PC) has not been fully investigated.

Methods: Patients who underwent surgical resection for radiologically resectable pancreatic cancer between 2002 and 2018 were included in this study. A clinicopathological examination focusing on pN0-PC was performed.

Results: Of all 533 patients, 155 (29.1%) were diagnosed with pN0-PC and 378 (70.9%) were diagnosed with node-positive pancreatic cancer (pN1/2-PC). The 5-year survival rates of patients with pN0-PC and pN1/2-PC were 57.1% and 25.0%, respectively (p < 0.001). A multivariate analysis revealed six prognostic factors in pN0-PC: age ≥ 70 years, nonadministration of adjuvant chemotherapy, anterior serosal invasion, nerve plexus invasion, and microscopic lymphatic and venous invasions. The 5-year survival rates of patients who had pN0-PC with 0-1 risk factor, with 2-3 risk factors, and with 4-6 risk factors were 87.6%, 47.9%, and 16.4%, respectively. Survival of patients who had pN0-PC with 4-6 risk factors was comparable to that of pN1/2 patients. The diagnostic capability of metastasis-negative lymph node was unsatisfactory, with a predictive value of < 43%.

Conclusions: Although the prognosis of patients with pN0-PC was better than that of patients with pN1/2-PC, it is not satisfactory. Survival of patients who had pN0-PC with 0-1 risk factors was extremely favorable; however, survival of patients who had pN0-PC with 4-6 risk factors was similar to those with pN1/2-PC.

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References

    1. Ferlay J, Colombet M, Soerjomataram I, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018;103:356–87. - DOI
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34. - DOI
    1. Center for Cancer Control and Information Services NCC. Projected Cancer Statistics, 2018. 2018; https://ganjoho.jp/en/public/statistics/short_pred.html .
    1. Matsuno S, Egawa S, Fukuyama S, et al. Pancreatic Cancer Registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30. - DOI
    1. Capussotti L, Massucco P, Ribero D, et al. Extended lymphadenectomy and vein resection for pancreatic head cancer: outcomes and implications for therapy. Arch Surg. 2003;138:1316–22. - DOI

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