The Lymph Node Ratio Is an Independent Prognostic Factor in Pancreatic Cancer Patients Who Receive Curative Resection Followed by Adjuvant Chemotherapy

Aoyama, Toru; Yamamoto, Naoto; Kamiya, Mako; Murakawa, Masaaki; Sawazaki, Sho; Numata, Masakatsu; Shiozawa, Manabu; Kobayashi, Satoshi; Ueno, Makoto; Morimoto, Manabu; Yukawa, Norio; Oshima, Takashi; Yoshikawa, Takaki; Rino, Yasushi; Masuda, Munetaka; Morinaga, Soichiro

doi:10.21873/anticanres.12801

Cited by 26 publications

(23 citation statements)

References 14 publications

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“…Lymph node density, or lymph node ratio, is considered a potential prognostic factor after surgery in patients with prostate, pancreatic, gastric, and esophageal malignancies. 5 - 8 Indeed, LND is more advantageous than the tumor-node-metastasis (TNM) classification system nodal staging system in predicting disease-specific survival (DSS), 9 recurrence-free survival, and overall survival (OS). 10 Likewise, in the head and neck region, LND also plays a predictive role for patients with oral cavity, thyroid, and laryngeal cancers.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Lymph Node Density in Patients With T3 and T4 Pyriform Sinus Carcinoma

Jia

Zhou

et al. 2020

Technol Cancer Res Treat

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Background/Aim: Lymph node density is a parameter used to more accurately predict tumor recurrence and patient survival. However, its association with surgical outcome in pyriform sinus carcinoma remains unclear. The purpose of this study was to assess the prognostic value of lymph node density in advanced pyriform sinus carcinoma. Patients and Methods: A total of 87 patients with pyriform sinus carcinoma treated between 2008 and 2015 were enrolled. Then, 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival, and 5-year regional recurrence-free survival were utilized to assess the prognostic significance of lymph node density. Results: With a median follow-up period of 31.8 months, 5-year overall survival, disease-specific survival, disease-free survival, and regional recurrence-free survival were 37.9%, 46.0%, 41.4%, and 54.0%, respectively. Univariate analysis revealed that lymph node density ≥ 0.093 was a significant predictor of poor 5-year overall survival ( P = .005), disease-specific survival ( P = .008), disease-free survival ( P = .0013), and regional recurrence-free survival ( P = .003). Furthermore, multivariate analysis demonstrated that lymph node density was negatively associated with adverse 5-year overall survival (hazard ratio = 1.62, 95% CI: 1.15-2.29, P = .006), disease-specific survival (hazard ratio = 1.86, 95% CI: 1.24-2.80, P = .003), disease-free survival (hazard ratio = 0.45, 95% CI: 0.24-0.85, P = .014), and regional recurrence-free survival (hazard ratio = 2.97, 95% CI: 1.43-6.17, P = .004). Conclusion: Taken together, these results reveal that lymph node density is a powerful prognostic factor for patients with T3 and T4 pyriform sinus carcinoma, and the median lymph node density cutoff values ≥ 0.093 are associated with a greater risk of recurrence and poorer survival.

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Section: Introductionmentioning

confidence: 99%

Prognostic Value of Lymph Node Density in Patients With T3 and T4 Pyriform Sinus Carcinoma

Jia

Zhou

et al. 2020

Technol Cancer Res Treat

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“…Hemopexin overexpression was found here to be associated with LN-metastasis number, venous invasion, lymphatic invasion, and LN ratio, which is also an accurate indicator of prognosis [36,37]. Intriguingly, tumor size did not differ between the groups, suggesting that hemopexin is more closely associated with invasion and metastasis than to tumor proliferation.…”

Section: Plos Onementioning

confidence: 48%

Stromal expression of hemopexin is associated with lymph-node metastasis in pancreatic ductal adenocarcinoma

et al. 2020

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Pancreatic ductal adenocarcinoma is one of the most aggressive types of cancer. Certain proteins in the tumor microenvironment have attracted considerable attention owing to their association with tumor invasion and metastasis. Here, we used proteomics to identify proteins associated with lymph-node metastasis, which is one of the prognostic factors. We selected lymph node metastasis-positive and-negative patients (n = 5 each) who underwent pancreatectomy between 2005 and 2015 and subjected to comprehensive proteomic profiling of tumor stroma. A total of 490 proteins were detected by mass spectrometry. Software analysis revealed that nine of these proteins were differentially expressed between the two patient groups. We focused on hemopexin and ferritin light chain based on immunohistochemistry results. We assessed the clinicopathological data of 163 patients and found that hemopexin expression was associated with UICC N2 (p = 0.0399), lymph node ratio (p = 0.0252), venous invasion (p = 0.0096), and lymphatic invasion (p = 0.0232). Notably, in vitro assays showed that hemopexin promotes invasion of the pancreatic cancer cells. Our findings suggest that hemopexin is a lymph node metastasis-associated protein that could potentially serve as a useful therapeutic target or biomarker of pancreatic ductal adenocarcinoma.

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“…This contrasts with the results of previous research. 47 One explanation is that because patients with advanced pancreatic cancer are ineligible for surgery, fewer cases of advanced N-stage and M-stage are detected and reported. Univariate and multivariate analyses demonstrated that high CSN6 expression is a risk factor for PDAC.…”

Section: Discussionmentioning

confidence: 99%

CSN6 expression is associated with pancreatic cancer progression and predicts poor prognosis

Shi

Guan

Zhan

et al. 2019

Cancer Biology & Therapy

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Constitutive photomorphogenesis 9 (COP9) signalosome 6 (CSN6) plays an essential role in tumor development. The present study aims to demonstrate that CSN6 is an important biomarker and has prognostic value for patients with pancreatic ductal adenocarcinoma (PDAC). We analyzed CSN6 expression levels in PDAC and adjacent non-cancerous tissues using immunohistochemistry (IHC) and quantitative real-time PCR (qPCR) analysis. We found that CSN6 was highly expressed in PDAC tissues, contrasting to adjacent non-cancerous tissues. Interestingly, CSN6 expression was positively associated with proliferating cell nuclear antigen (PCNA) expression. Further investigation indicated that CSN6 knockdown significantly suppressed the proliferation of PDAC cells and decreased the expression levels of PCNA, while CSN6 overexpression increased the proliferation, as well as the expression levels of PCNA in PDAC cells. Furthermore, a χ 2 test indicated that the expression of CSN6 in PDAC tissues was markedly associated with tumor infiltration and serum carbohydrate antigen 19-9 levels. In addition, univariate and multivariate analyses showed that CSN6 levels were significantly correlated with poor clinical outcomes of patients with PDAC. Kaplan-Meier analysis showed that patients with high expression of CSN6 had shorter overall survival. These results suggest that the expression of CSN6 correlates with the progression of PDAC, resulting in poor prognosis. Thus, CSN6 may play a significant role in the development of PDAC and is a potential target to prevent and treat PDAC.

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The Lymph Node Ratio Is an Independent Prognostic Factor in Pancreatic Cancer Patients Who Receive Curative Resection Followed by Adjuvant Chemotherapy

Abstract: The LNR was a risk factor for overall survival in patients who underwent curative surgery followed by adjuvant chemotherapy for pancreatic cancer. It is necessary to develop strategies to effectively utilize the lymph node metastasis status.

Cited by 26 publications

References 14 publications

Prognostic Value of Lymph Node Density in Patients With T3 and T4 Pyriform Sinus Carcinoma

Prognostic Value of Lymph Node Density in Patients With T3 and T4 Pyriform Sinus Carcinoma

Stromal expression of hemopexin is associated with lymph-node metastasis in pancreatic ductal adenocarcinoma

CSN6 expression is associated with pancreatic cancer progression and predicts poor prognosis

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