Impact of lymph node ratio on survival in patients with pancreatic and periampullary cancer

Tol, Johanna A. M. G.; Brosens, L.; Dieren, Susan van; Gulik, Thomas M. van; Busch, Olivier R.; Besselink, Marc G.; Gouma, Dirk J.

doi:10.1002/bjs.9709

Cited by 110 publications

(88 citation statements)

References 48 publications

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“…Sensitivity analysis was performed for PDAC separately, as outcomes may differ from periampullary (distal CBD, papilla, duodenum) cancers, and clear differences exist in survival between the various periampullary cancers and PDAC. 35,36 Therefore, some of the largest studies in this review describing only 'cancer of the pancreatic head' which may involve distal cholangiocarcinoma were excluded from sensitivity analysis. Survival in patients with PDAC and LNM was shorter compared to patients with other periampullary cancers and LNM: survival in patients with PDAC and hepatic-artery or para-aortic LNM was 13 and 11 months, respectively, compared to 15 and 13 months for all patients.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: A systematic review and meta-analysis

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: A systematic review and meta-analysis

et al. 2016

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“…Lymph-nodes status is one of the most powerful predictors of survival after resection in patients with periampullary cancer [34] . By performing a more detailed analysis, we have shown that the median survival was impaired in stented patients independent of lymph-node status.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Endoscopic Biliary Drainage May Negatively Impact Survival Following Pancreatoduodenectomy for Ampullary Cancer

Barauskas

Urbonas²,

Smailytė³

et al. 2016

Dig Surg

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Background/Aims: Ampullary carcinoma is a rare tumour with a high resectability rate. There is an increasing body of evidence indicating not only tumour-related factors, but also jaundice influence survival following curative resection. Several modalities for preoperative biliary drainage are available; however, routine preoperative endoscopic biliary drainage (PEBD) is not recommended. There is no sufficient data regarding the impact of PEBD on long-term outcomes. The aim of our study was to identify predictive factors of survival with special regard to PEBD in patients undergoing curative resection for ampullary carcinoma. Patients and Methods: Data from 64 consecutive patients with adenocarcinoma of the papilla of Vater who have been operated on was analysed. Overall survival was defined from the date of surgery to the date of death, or censored at the last patient contact. Survival analysis was determined by means of the Kaplan-Meier method. The significance of the demographic, clinical and histopathologic factors was ascertained by the log-rank test. A Cox proportional hazard model was used to determine independent prognostic factors of survival. Results: Twenty patients (31.2%) underwent PEBD. Univariate analysis revealed tumour-related factors, age over 70, and PEBD to negatively influence survival. Five of them (excluding T stage) were identified as the independent prognosticators, while PEBD appeared to be the most decisive factor. Median survival for patients who underwent PEBD was 25.3 months as compared to 112.9 months for those who did not. In conclusion, PEBD negatively affected long-term outcomes in our patients with resected ampullary carcinoma.

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“…The relative prognostic value of each of these lymph node-/lymphatic vasculature-specific metrics is controversial. Prospective and retrospective clinical studies evaluating the utility of these criteria are collected in Table 2 [6,33,38,44,51,62,63,101–104,106–114]. Contradictory conclusions from these studies highlight the remaining need for additional work before use of these metrics is informative in the general clinical setting.…”

Section: Outcomes Prediction: Lymphatic-specific Metricsmentioning

confidence: 99%

The lymphatic system and pancreatic cancer

2016

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This review summarizes current knowledge of the biology, pathology and clinical understanding of lymphatic invasion and metastasis in pancreatic cancer. We discuss the clinical and biological consequences of lymphatic invasion and metastasis, including paraneoplastic effects on immune responses and consider the possible benefit of therapies to treat tumors that are localized to lymphatics. A review of current techniques and methods to study interactions between tumors and lymphatics is presented.

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Impact of lymph node ratio on survival in patients with pancreatic and periampullary cancer

Abstract: LNR is a common predictor of poor survival in pancreatic, distal CBD and ampullary cancer.

Cited by 110 publications

References 48 publications

Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: A systematic review and meta-analysis

Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: A systematic review and meta-analysis

Preoperative Endoscopic Biliary Drainage May Negatively Impact Survival Following Pancreatoduodenectomy for Ampullary Cancer

The lymphatic system and pancreatic cancer

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