Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma

Yasunari Fukuda, Tadafumi Asaoka, Sakae Maeda, Naoki Hama, Atsushi Miyamoto, Masaki Mori, Yuichiro Doki, Shoji Nakamori

Research output: Contribution to journalArticle

Abstract

Background The present study aimed to clarify the prognostic impact of nodal statuses in pancreatic ductal adenocarcinoma (PDAC) after potentially curative pancreatectomy. Methods In 110 patients with >10 examined lymph nodes (ELNs), we investigated how nodal statuses were associated with postoperative survival. Nodal statuses included the number of positive LNs (PLNs); the ratio of PLNs to ELNs (lymph node ratio; LNR); and the location of regional LN metastases, classified as group one (peripancreatic area) and group 2 (outside the peripancreatic area). The maximum χ 2 value, provided by a Cox proportional hazards model, was used to determine the optimal cutoff value for the number of PLNs and the LNR. Results The median numbers of ELNs and metastatic LNs were 33 and 2, respectively. Median survival was longer in patients with ≤3 PLNs (37.5 months), LNR <0.11 (36.1 months), and group 1 LN metastases (37.5 months) compared to in patients with ≥4 PLNs (23.7 months), LNR ≥0.11 (23.9 months), and group 2 LN metastases (22.8 months), respectively. Multivariate analyses revealed that all three investigated nodal statuses were independent factors associated with survival: HR of 2.38 and p = 0.0006 for the location of LN metastases, HR of 1.92 and p = 0.0071 for the number of PLNs, and HR of 1.89 and p = 0.010 for the LNR. Conclusions Three nodal statuses—the number of PLNs, the LNR, and the location of LN metastases—could stratify postoperative survival among PDAC patients with an adequate number of examined LNs after pancreatectomy.

Original languageEnglish
Pages (from-to)279-284
Number of pages6
JournalPancreatology
Volume17
Issue number2
DOIs
Publication statusPublished - Mar 1 2017
Externally publishedYes

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Adenocarcinoma
Lymph Nodes
Neoplasm Metastasis
Pancreatectomy
Survival
Proportional Hazards Models
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

Cite this

Fukuda, Y., Asaoka, T., Maeda, S., Hama, N., Miyamoto, A., Mori, M., ... Nakamori, S. (2017). Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma. Pancreatology, 17(2), 279-284. https://doi.org/10.1016/j.pan.2017.01.003

Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma. / Fukuda, Yasunari; Asaoka, Tadafumi; Maeda, Sakae; Hama, Naoki; Miyamoto, Atsushi; Mori, Masaki; Doki, Yuichiro; Nakamori, Shoji.

In: Pancreatology, Vol. 17, No. 2, 01.03.2017, p. 279-284.

Research output: Contribution to journalArticle

Fukuda, Y, Asaoka, T, Maeda, S, Hama, N, Miyamoto, A, Mori, M, Doki, Y & Nakamori, S 2017, 'Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma', Pancreatology, vol. 17, no. 2, pp. 279-284. https://doi.org/10.1016/j.pan.2017.01.003
Fukuda, Yasunari ; Asaoka, Tadafumi ; Maeda, Sakae ; Hama, Naoki ; Miyamoto, Atsushi ; Mori, Masaki ; Doki, Yuichiro ; Nakamori, Shoji. / Prognostic impact of nodal statuses in patients with pancreatic ductal adenocarcinoma. In: Pancreatology. 2017 ; Vol. 17, No. 2. pp. 279-284.
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AU - Fukuda, Yasunari

AU - Asaoka, Tadafumi

AU - Maeda, Sakae

AU - Hama, Naoki

AU - Miyamoto, Atsushi

AU - Mori, Masaki

AU - Doki, Yuichiro

AU - Nakamori, Shoji

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N2 - Background The present study aimed to clarify the prognostic impact of nodal statuses in pancreatic ductal adenocarcinoma (PDAC) after potentially curative pancreatectomy. Methods In 110 patients with >10 examined lymph nodes (ELNs), we investigated how nodal statuses were associated with postoperative survival. Nodal statuses included the number of positive LNs (PLNs); the ratio of PLNs to ELNs (lymph node ratio; LNR); and the location of regional LN metastases, classified as group one (peripancreatic area) and group 2 (outside the peripancreatic area). The maximum χ 2 value, provided by a Cox proportional hazards model, was used to determine the optimal cutoff value for the number of PLNs and the LNR. Results The median numbers of ELNs and metastatic LNs were 33 and 2, respectively. Median survival was longer in patients with ≤3 PLNs (37.5 months), LNR <0.11 (36.1 months), and group 1 LN metastases (37.5 months) compared to in patients with ≥4 PLNs (23.7 months), LNR ≥0.11 (23.9 months), and group 2 LN metastases (22.8 months), respectively. Multivariate analyses revealed that all three investigated nodal statuses were independent factors associated with survival: HR of 2.38 and p = 0.0006 for the location of LN metastases, HR of 1.92 and p = 0.0071 for the number of PLNs, and HR of 1.89 and p = 0.010 for the LNR. Conclusions Three nodal statuses—the number of PLNs, the LNR, and the location of LN metastases—could stratify postoperative survival among PDAC patients with an adequate number of examined LNs after pancreatectomy.

AB - Background The present study aimed to clarify the prognostic impact of nodal statuses in pancreatic ductal adenocarcinoma (PDAC) after potentially curative pancreatectomy. Methods In 110 patients with >10 examined lymph nodes (ELNs), we investigated how nodal statuses were associated with postoperative survival. Nodal statuses included the number of positive LNs (PLNs); the ratio of PLNs to ELNs (lymph node ratio; LNR); and the location of regional LN metastases, classified as group one (peripancreatic area) and group 2 (outside the peripancreatic area). The maximum χ 2 value, provided by a Cox proportional hazards model, was used to determine the optimal cutoff value for the number of PLNs and the LNR. Results The median numbers of ELNs and metastatic LNs were 33 and 2, respectively. Median survival was longer in patients with ≤3 PLNs (37.5 months), LNR <0.11 (36.1 months), and group 1 LN metastases (37.5 months) compared to in patients with ≥4 PLNs (23.7 months), LNR ≥0.11 (23.9 months), and group 2 LN metastases (22.8 months), respectively. Multivariate analyses revealed that all three investigated nodal statuses were independent factors associated with survival: HR of 2.38 and p = 0.0006 for the location of LN metastases, HR of 1.92 and p = 0.0071 for the number of PLNs, and HR of 1.89 and p = 0.010 for the LNR. Conclusions Three nodal statuses—the number of PLNs, the LNR, and the location of LN metastases—could stratify postoperative survival among PDAC patients with an adequate number of examined LNs after pancreatectomy.

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