Effect of the number of positive lymph nodes and lymph node ratio on prognosis of patients after resection of pancreatic adenocarcinoma

Liu, Zu Qiang; Xiao, Zhi; Luo, Guopei; Liu, Liang; Liu, Chen; Xu, Jin; Jiang, Long; Ni, Quan Xing; Lei, Yu

doi:10.1016/s1499-3872(14)60264-2

Cited by 23 publications

(32 citation statements)

References 30 publications

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“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] There were 5 prospective studies, 1 randomised controlled trial and 13 retrospective studies (Table 1). All included studies analysed survival using the Kaplan-Meier method, defining an event as the death of a patient and overall survival from the time elapsed from surgery to death.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Association between these subgroups and overall survival was investigated and presented using Kaplan-Meier curves. A high lymph node ratio was associated with decreased overall survival in 17 studies, [13][14][15][16][17][18][19][20][21][22][24][25][26][27][28]30,31 and no association was found in two studies. 23,29 Lymph node ratio was significantly associated with overall survival in most studies.…”

Section: Lymph Node Ratio Association With Overall Survivalmentioning

confidence: 99%

“…14, [16][17][18][19][20][21][22][23][24][25][28][29][30][31] Total nodes examined was not linked with overall survival in 12 studies. 14,[16][17][18][20][21][22][23][24][25]30,31 Only three studies showed that an increase in total nodes examined was associated with improved overall survival.…”

Section: Number Of Positive Nodes Association With Overall Survivalmentioning

confidence: 99%

“…14,[16][17][18][20][21][22][23][24][25]30,31 Only three studies showed that an increase in total nodes examined was associated with improved overall survival. 19,28,29 Total nodes examined was not associated with overall survival in most studies.…”

Section: Number Of Positive Nodes Association With Overall Survivalmentioning

confidence: 99%

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A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

Elshaer

Gravante

Kosmin

et al. 2017

annals

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BACKGROUND Pancreatic ductal adenocarcinoma is the most common pancreatic cancer. Five-year overall survival is currently 3.3-6.0%. The aim of this review was to evaluate the prognostic value of lymph node ratio, number of positive nodes and total nodes examined on overall survival rate following pancreatic resection. MATERIALS AND METHODS A literature search was conducted of MEDLINE, EMBASE, the Cochrane Library and Central Register of Controlled Trials and the Cochrane Database of Systematic Review databases, from January 1996 to January 2016. RESULTS Overall, 19 studies including 4,883 patients examined the relationship between lymph node ratio and overall survival. A high lymph node ratio was associated with decreased overall survival in 17 studies. A total of 12 studies examined the relationship between the number of positive nodes and overall survival, and 11 studies revealed that an increase in the number of positive nodes was associated with decreased overall survival. In 15 studies examining the relationship between the total nodes examined and overall survival, there was no association with overall survival in 12 studies. CONCLUSIONS Lymph node ratio and number of positive nodes are factors associated with overall survival in pancreatic ductal adenocarcinoma, but not total nodes examined.

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Lymph Node Ratio Association With Overall Survivalmentioning

confidence: 99%

Section: Number Of Positive Nodes Association With Overall Survivalmentioning

confidence: 99%

Section: Number Of Positive Nodes Association With Overall Survivalmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

Elshaer

Gravante

Kosmin

et al. 2017

annals

View full text Add to dashboard Cite

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“…Surgical pathology QIs were met when reporting included an accurate description of the number of lymph nodes identified in the specimen [20], presence or absence of the description regarding tumor characteristics such as grade of cellular differentiation, histology, maximum size of the neoplastic mass, total number of lymph nodes containing evidence of malignant cells, presence or absence of tumor along the surgical margins (R0, vs. R1/ R2 resections), presence or absence of lymphovascular or perineural tumor invasion, and the final TNM stage according to American Joint Committee on Cancer (AJCC) Staging Manual [21].…”

Section: Icd Codes Used For Identification Of Location Of Pancreatic mentioning

confidence: 99%

Are Quality Indicators associated with Postoperative Outcomes after Resection for Pancreatic Adenocarcinoma?

Hurton¹,

Urquhart²,

Kendall³

et al. 2016

Pancreat Disord Ther

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Evaluation of Lymph Node Ratio Association With Long-term Patient Survival After Surgery for Node-Positive Merkel Cell Carcinoma

2019

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IMPORTANCE Merkel cell carcinoma (MCC) carries the highest mortality rate among cutaneous cancers and is rapidly rising in incidence. Identification of prognostic indicators may help guide patient counseling and treatment planning. Lymph node ratio (LNR), the ratio of positive lymph nodes to the total number of examined lymph nodes, is an established prognostic indicator in other cancers. OBJECTIVES The primary objective was to evaluate the association between LNR and patient survival after surgery for node-positive MCC. The secondary objective was to evaluate whether the survival rates associated with adjuvant therapies vary by patient LNR status. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of patients with node-positive MCC treated with surgery and lymphadenectomy. We queried the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) registry for patient records. Data originated from 2004 through 2017 for the NCDB and from 1973 through 2016 for the SEER registry. The SEER registry comprises a population-based US cohort while cases from the NCDB include all reportable cases from Commission on Cancer-accredited facilities and represents approximately 70% of all newly diagnosed cancers in the United States. All data analysis took place between August 1, 2018, and February 11, 2019. EXPOSURES The ratio of positive lymph nodes to the total number of examined lymph nodes, LNR, was stratified into quartiles. MAIN OUTCOMES AND MEASURES Overall survival (NCDB) and disease-specific survival (SEER). RESULTS We identified 736 eligible cases in the NCDB and 538 eligible cases in the SEER registry. Among these 1274 patients, the mean (SD) age was 71.1 (11.5) years, and 401 (31.5%) were women. After controlling for clinical and tumor factors including AJCC N staging, patient LNR of 0.07 to 0.31 (hazard ratio [HR], 1.37; 95% CI, 1.03-1.81) and greater than 0.31 (HR, 2.84; 95% CI, 2.10-3.86) was associated with significantly worse survival than an LNR less than 0.07. Univariate supplementary analysis performed in the SEER data set revealed a similar association of LNR with disease-specific survival. For patients with an LNR greater than 0.31, treatment with surgery and adjuvant chemoradiation therapy was associated with improved survival compared with surgery and adjuvant radiation therapy alone (HR, 0.61; 95% CI, 0.38-0.97), while this was not found for patients with an LNR of 0.31 or lower (HR, 0.93; 95% CI, 0.65-1.33). CONCLUSIONS AND RELEVANCE For lymph node-positive MCC, LNR offers a potentially prognostic metric alongside traditional TNM staging that may be useful for both patient counseling and treatment planning after surgery.

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Effect of the number of positive lymph nodes and lymph node ratio on prognosis of patients after resection of pancreatic adenocarcinoma

Cited by 23 publications

References 30 publications

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

Are Quality Indicators associated with Postoperative Outcomes after Resection for Pancreatic Adenocarcinoma?

Evaluation of Lymph Node Ratio Association With Long-term Patient Survival After Surgery for Node-Positive Merkel Cell Carcinoma

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