Premium
Role of the Lymph node ratio in pancreatic ductal adenocarcinoma. Impact on patient stratification and prognosis
Author(s) -
La Torre Marco,
Cavallini Marco,
Ramacciato Giovanni,
Cosenza Giulia,
del Monte Simone Rossi,
Nigri Giuseppe,
Ferri Mario,
Mercantini Paolo,
Ziparo Vincenzo
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22013
Subject(s) - medicine , grading (engineering) , lymph node , hazard ratio , adenocarcinoma , pancreatic ductal adenocarcinoma , proportional hazards model , resection margin , pancreaticoduodenectomy , oncology , gastroenterology , survival analysis , lymph , overall survival , pancreatic cancer , surgery , resection , pancreas , cancer , pathology , confidence interval , civil engineering , engineering
Background Survival after resection of pancreatic adenocarcinoma is poor. Several prognostic factors such as the status of the resection margin, lymph node status, or tumor grading have been identified. Aim of the study was to evaluate the prognostic significance of the lymph node ratio (LNR) for resected pancreatic ductal adenocarcinoma. Materials and Methods Data were collected from 101 patients who had undergone pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Patients were divided into four groups according to the absolute LNR (0, 0–0.199, 0.2–0.399, >0.4). Kaplan–Meier and Cox proportional hazard models were used to evaluate the prognostic effect. Results The actuarial 3‐ and 5‐year survival rates were 32 and 17%, respectively. The median survival was 19 months. Patients with LNR 0/0–0.199/0.2–0.399/>0.4 survived 40.2/30.5/18.1, and 13.6 months, respectively ( P = 0.001). At the multivariate analysis, lymph node status was not found to be a significant prognostic factor; on the contrary LNR >0.2 ( P = 0.007), positive resection margin ( P = 0.001), and grading ( P = 0.05) were significantly related to survival. Conclusion LNR is a more powerful predictor of survival than the lymph node status in patients undergoing pancreaticoduodenectomy for ductal adenocarcinoma. J. Surg. Oncol. 2011; 104:629–633. © 2011 Wiley Periodicals, Inc.