Number of Metastatic Lymph Nodes, but Not Lymph Node Ratio, Is an Independent Prognostic Factor after Resection of Pancreatic Carcinoma

Murakami, Yoshiaki; Uemura, Kenichiro; Sudo, Takeshi; Hayashidani, Yasuo; Hashimoto, Yasushi; Nakashima, Akira; Yuasa, Yuki; Kondo, Naru; Ohge, Hiroki; Sueda, Taijiro

doi:10.1016/j.jamcollsurg.2010.03.037

Cited by 143 publications

(133 citation statements)

References 36 publications

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“…In total, 189 cancers were located at the head or neck of the pancreas, 110 cases at the body and tail of the pancreas and 3 cases had spread to the entire pancreas. In addition, 8 Statistical analyses. Survival curves were constructed by the Kaplan-Meier method.…”

Section: Methodsmentioning

confidence: 99%

“…For example, a recent Japanese study calculated the Onodera's prognostic nutrition index (PNI), based on serum albumin and three other constitutive indices, to be an independent prognostic factor useful in the prediction of survival of pancreatic cancer patients (7). In addition, other studies have focused on utilizing the characteristics of the tumor phenotype, such as the number of metastatic lymph nodes (8), tumor invasion or adhesion to peripancreatic blood vessels and positive margins following pancreatoduodenectomy (9,10) as prognostic factors for pancreatic cancer. However, to date, there are no studies found to associate the clinicopathological characteristics with pancreatic cancer prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors in patients with pancreatic cancer

Zhang

Dai

Yuan

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The identification of prognostic factors for pancreatic cancer patients could provide insightful information for their management in the clinic. A total of 302 pancreatic cancer patients were enrolled in this study. The clinicopathological characteristics, treatment selection and laboratory test data were retrospectively retrieved from the medical records and follow-up data were obtained via telephone interview. Cox survival analysis was used to assess the potential prognostic factors, and survival curves were obtained by Kaplan-Meier analyses. The mortality rate of the patients was 83.4% (252/302) and the median survival of these patients was 6.1 months, with 1-, 2-and 3-year survival rates of 30.1 (91/302), 10.6 (32/302) and 2.6% (8/302), respectively. The most influential factors for the survival of these patients were the site of primary cancer, tumor stage, treatment selection, serum levels of glutamic-pyruvic transaminase, albumin, lactate dehydrogenase and hemoglobin, and white blood cell counts (P<0.05). The median survival of patients who did not receive any treatment or just received supportive treatment was 1.3 months, while the median overall survival of patients who underwent surgery, chemotherapy, biliary drainage therapy, arterial interventional chemotherapy and comprehensive treatment was 11.0, 7.3, 3.5, 9.0 and 11.0 months, respectively (P<0.05). Furthermore, single-drug chemotherapy was not statistically associated with patient survival in those who received the multi-drug regimen (P>0.05). However, the mortality risk of patients who received platinum chemotherapy was decreased [hazard ratio (HR)=0.56, 95% CI 0.35-0.88, P=0.011] compared to the patients who did not receive this treatment (P<0.05). Tumor stage, treatment selection, serum albumin levels, urea nitrogen, CA19-9, white blood cell and platelet counts were independent prognostic factors for the prediction of survival in pancreatic cancer. Future studies are required in order to verify these data.Chemotherapy with platinum regimens could improve overall survival in patients with pancreatic cancer.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic factors in patients with pancreatic cancer

Zhang

Dai

Yuan

et al. 2011

Experimental and Therapeutic Medicine

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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%

“…Only four studies did not report the nodal and R status. 28,[30][31][32] Adjuvant therapy (chemoradiotherapy) data were available in 10 studies that included 1,739 patients (36%), 13,14,19,[21][22][23]26,[28][29][30] and data on neoadjuvant therapy were available in only two studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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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“…Slidell et al showed that; not only the number of lymph node, but also LNR (ratio of metastatic lymph nodes to total number of examined lymph nodes) may be releated with more directive for postoperative survival (24). However, Murakami et al suggested that the number of metastatic lymph node is more potent prognostic factor than LNR in the 119 patients that pancreatectomy is applied (25). In our country, Büyükkaşık et al showed that; wide surgical resection of gastric cancer, increased mortality especially over the age of 70, as well as in pancreatic cancer (26).…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic Prognostic Factors in Locally Advanced Pancreatic Cancer Patients Treated with Radiation Therapy

Kaya¹

2015

Ann Clin Anal Med

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Anahtar KelimelerPankreas Kanseri; Radyoterapi; Lenf Nodu Durumu; Tümör Çapı Abstract Aim: The prognosis of pancreatic cancer is one of the worst malignancies. In randomized clinical trials done in recent times, the answer is researched for adjuvant chemotherapy, chemoradiotherapy. Our study investigated the clinicopathologic prognostic factors for pancreatic cancer. Material and Method: Patients diagnosed with histopathologically confirmed pancreatic cancer, followed by Akdeniz University School of Medicine, Department of Radiation Oncology between the years 2000-2008 were included in the study. Results: A total number of 32 patients were taken to the study. The tumor diameter values in predicting survival were analyzed using ROC (Receiver Operating Characteristics) curve analysis. Patients were grouped according to their tumor diameters: the tumor diameter lower than 4 cm (Group A), the tumor diameter higher than 4 cm (Group B). The mean survival of patients is determined as 17.3 months. The fact that there is whether or not lymph node involvement is found to be related with survival (p=0.009). A significant relationship between Group A and B in terms of survival is determined (p=0.029). Conclusions: While treatment is considered in patients who are planned to receive radiation therapy because of pancreatic cancer, the tumor diameter and the lymph node status should be taken into account as prognostic factors.

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Number of Metastatic Lymph Nodes, but Not Lymph Node Ratio, Is an Independent Prognostic Factor after Resection of Pancreatic Carcinoma

Cited by 143 publications

References 36 publications

Prognostic factors in patients with pancreatic cancer

Prognostic factors in patients with pancreatic cancer

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

Clinicopathologic Prognostic Factors in Locally Advanced Pancreatic Cancer Patients Treated with Radiation Therapy

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