The Number and Ratio of Positive Lymph Nodes Affect Pancreatic Cancer Patient Survival After Neoadjuvant Therapy and Pancreaticoduodenectomy

Overview

Journal Histopathology

Specialties Anatomy & Histology
Pathology

Date 2015 May 7

PMID 25945396

Citations 27

Authors

Laurice K Fischer

Matthew H Katz

Sun M Lee

Li Liu

Hua Wang

Gauri R Varadhachary

Robert A Wolff

Jeffrey E Lee

Anirban Maitra

Christina L Roland

Jason B Fleming

Jeannelyn Estrella

Asif Rashid

Huamin Wang

Affiliations

Soon will be listed here.

Abstract

Aims: This study is to examine the significance of the number and ratio of positive nodes in post-neoadjuvant therapy pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).

Methods And Results: Our study population consisted of 398 consecutive PDAC patients, who completed neoadjuvant therapy and PD between 1999 and 2012. Lymph node status was classified as ypN0 (node-negative), ypN1 (1-2 positive nodes) and ypN2 (≥3 positive nodes) and correlated with disease-free survival (DFS) and overall survival (OS). The ypN0, ypN1 and ypN2 was present in 183 (46.0%), 117 (29.4%) and 98 (24.6%) patients, respectively. Additionally, 162 (40.7%) had a lymph node ratio (LNR) ≤0.19 and 53 (13.3%) had a LNR >0.19. Patients with ypN1 disease had shorter DFS and OS than those with ypN0 disease, but better DFS and OS than those with ypN2 disease (P < 0.05). Similarly, patients with a LNR ≤ 0.19 had better DFS and OS than those with a LNR > 0.19 (P < 0.001). In multivariate analysis, both the number of positive nodes and LNR were independent prognostic factors for DFS and OS.

Conclusions: Subclassification of post-therapy node-positive group into ypN1 (1-2 positive nodes) and ypN2 (≥3 positive nodes) should be incorporated into the American Joint Committee on Cancer (AJCC) staging of PDAC patients.

Citing Articles

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