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Erschienen in: Journal of Gastrointestinal Surgery 2/2013

01.02.2013 | 2012 SSAT Poster Presentation

N0/N1, PNL, or LNR? The Effect of Lymph Node Number on Accurate Survival Prediction in Pancreatic Ductal Adenocarcinoma

verfasst von: Nakul P. Valsangkar, Devon M. Bush, James S. Michaelson, Cristina R. Ferrone, Jennifer A. Wargo, Keith D. Lillemoe, Carlos Fernández-del Castillo, Andrew L. Warshaw, Sarah P. Thayer

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 2/2013

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Abstract

Introduction

We evaluated the prognostic accuracy of LN variables (N0/N1), numbers of positive lymph nodes (PLN), and lymph node ratio (LNR) in the context of the total number of examined lymph nodes (ELN).

Methods

Patients from SEER and a single institution (MGH) were reviewed and survival analyses performed in subgroups based on numbers of ELN to calculate excess risk of death (hazard ratio, HR).

Results

In SEER and MGH, higher numbers of ELN improved the overall survival for N0 patients. The prognostic significance (N0/N1) and PLN were too variable as the importance of a single PLN depended on the total number of LN dissected. LNR consistently correlated with survival once a certain number of lymph nodes were dissected (≥13 in SEER and ≥17 in the MGH dataset).

Conclusions

Better survival for N0 patients with increasing ELN likely represents improved staging. PLN have some predictive value but the ELN strongly influence their impact on survival, suggesting the need for a ratio-based classification. LNR strongly correlates with outcome provided that a certain number of lymph nodes is evaluated, suggesting that the prognostic accuracy of any LN variable depends on the total number of ELN.
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Metadaten
Titel
N0/N1, PNL, or LNR? The Effect of Lymph Node Number on Accurate Survival Prediction in Pancreatic Ductal Adenocarcinoma
verfasst von
Nakul P. Valsangkar
Devon M. Bush
James S. Michaelson
Cristina R. Ferrone
Jennifer A. Wargo
Keith D. Lillemoe
Carlos Fernández-del Castillo
Andrew L. Warshaw
Sarah P. Thayer
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 2/2013
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-012-1974-7

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