Lymph Node Ratio as Valuable Predictor in Pancreatic Cancer Treated with R0 Resection and Adjuvant Treatment

You, Min Su; Paik, Woo Hyun; Ryu, Ji Kon; Kim, Yong‐Tae; Huh, Gunn; Chun, Jung Won; Jang, Dong Kee

doi:10.1016/j.pan.2019.05.278

Cited by 6 publications

(15 citation statements)

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“…and A.C.) independently evaluated each of the studies using the Newcastle-Ottawa scale. The information of the studies included in shown in Table 1 [ 2 - 4 , 7 , 9 - 18 ]. The study was designated to be of poor quality if it did not meet more than one of the criteria in the selection domain, no score in the compatibility domain, and did not meet more than one of the criteria in the outcome domain.…”

Section: Methodsmentioning

confidence: 99%

“…Prognostic impact of lymph nodal metastasis can be assessed by using various methods such as the presence of positive LNs, total number of LNs, ratio of positive to total LNs, and also ratio of positive to negative LNs [ 7 ]. It should be noted that considering the number of positive LN involved to categorize nodal disease and to predict prognosis has been inaccurate.…”

Section: Introductionmentioning

confidence: 99%

“…In recent times, LN ratio (LNR) is being evaluated as a prognostic indicator in several of the published studies apart from just using the number of positive LN [ 2 - 4 , 7 - 18 ]. The LNR is defined as the ratio of metastatic to the total number of harvested LNs, and it has emerged as an indicator of cancer-specific survival in recent years.…”

Section: Introductionmentioning

confidence: 99%

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Lymph Node Ratio as a Prognostic Marker in Pancreatic Cancer Survival: A Systematic Review and Meta-Analysis

Karjol

Chandranath

Jonnada

et al. 2020

Cureus

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The lymph node ratio (LNR) is defined as the ratio of number of positive lymph nodes to the total number of lymph nodes harvested during surgery. The objective of this article is to investigate the efficacy of LNR as a prognostic indicator of survival in pancreatic cancer patients who have undergone surgery by meta-analysis. Methods A systematic database search was performed in MEDLINE, Embase, and Google Scholar for relevant studies that reported LNR in pancreatic cancer. Two authors independently screened the relevant articles for selection and to extract data. All studies published in English up to April 2020 were obtained, and a total of 17,128 node-positive patients in 14 studies were included in this meta-analysis. RevMan software 5.3 (Cochrane Collaboration, the Nordic Cochrane Centre, Copenhagen, Denmark) was used for conducting all statistical analyses. Results This meta-analysis demonstrated that LNR > 0.2 significantly correlated with worse survival (hazard ratio [HR]: 1.84; 95% CI: 1.74-1.94; p ≤ 0.00001) in node-positive pancreatic cancer patients. Conclusions Our findings have demonstrated that a higher LNR is a predictor of poor survival and that LNR serves as an independent prognostic marker for assessing survival using a cutoff of 20%.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lymph Node Ratio as a Prognostic Marker in Pancreatic Cancer Survival: A Systematic Review and Meta-Analysis

Karjol

Chandranath

Jonnada

et al. 2020

Cureus

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“…The presence of cancerous cells in the lymph node (LN) negatively correlates with patient survival in many cancer types ( Fortea-Sanchis et al., 2018 ; Pai et al., 2011 ; You et al., 2019 ). Yet as many as 45% of patients have LN involvement, and a startling 89% have disseminated tumor cells within their LNs in the context of colon and pancreatic cancers, respectively ( Weledji et al., 2016 ; Wong, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Lymph Node Subcapsular Sinus Microenvironment-On-A-Chip Modeling Shear Flow Relevant to Lymphatic Metastasis and Immune Cell Homing

et al. 2020

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Summary A lymph node sinus-on-a-chip adhesion microfluidic platform that recapitulates the hydrodynamic microenvironment of the lymph node subcapsular sinus was engineered. This device was used to interrogate the effects of lymph node remodeling on cellular adhesion in fluid flow relevant to lymphatic metastasis. Wall shear stress levels analytically estimated and modeled after quiescent and diseased/inflamed lymph nodes were experimentally recapitulated using a flow-based microfluidic perfusion system to assess the effects of physiological flow fields on human metastatic cancer cell adhesion. Results suggest that both altered fluid flow profiles and presentation of adhesive ligands, which are predicted to manifest within the lymph node subcapsular sinus as a result of inflammation-induced remodeling, and the presence of lymph-borne monocytic cells may synergistically contribute to the dynamic extent of cell adhesion in flow relevant to lymph node invasion by cancer and monocytic immune cells during lymphatic metastasis.

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“…In recent years, LNR has been considered as an independent prognostic predictor of survival in PDAC patients better than positive lymph nodes for patients after resection of pancreatic cancer [32][33][34].It is not surprising that LNR could be used to assess the survival of resected pancreatic SRCC. But at present, the role of LNR in predicting survival of resected pancreatic SRCC is unclear.…”

Section: Discussionmentioning

confidence: 99%

The value of lymph node ratio and total number of lymph nodes examined for resected pancreatic signet ring cell carcinoma: a retrospective cohort study

Ren¹,

Xue²,

Wu³

et al. 2020

Preprint

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Background—Pancreatic signet ring cell carcinoma (SRCC) was an exceedingly rare histological subtype of pancreatic cancer. Previous studies focused on the trends of incidence and independent predictors of pancreatic SRCC. Our objectives of the study was to analyze the prognostic value of lymph node ratio (LNR) and explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic signet ring cell carcinoma.Method—The data diagnosed from January 1, 1990 to December 31, 2016 constituted the study cohort from the Surveillance, Epidemiology, and End Results(SEER) registry. We calculated overall survival (OS) of these patients using Kaplan–Meier analysis and Cox proportional hazards model and used receiver-operating characteristic curve (ROC) analysis to investigate the discriminatory ability of the total number of lymph nodes examined(TNLE) relative to whether lymph node metastasis.Results—The median number of lymph nodes examined among 120 patients of resected pancreatic SRCC was 14 (interquartile range, 6.25 to 20.0).According to the univariate analysis of overall survival(OS) result, age, grade, chemotherapy, LNR and TNLE were significantly different(P<0.05).Multivariate survival analysis showed that LNR and grade were the independent prognostic indicators after pancreatic SRCC resection for OS. TNLE ≥ 8 showed the highest discriminatory power to evaluate whether the lymph node metastasis (AUC 0.656, 95%CI 0.564-0.741, Youden index 0.2533, sensitivity 78.67%, specificity 46.67%, P= 0.003)Conclusion—Our study indicated that LNR was a valuable independent prognostic factor for resected pancreatic SRCC. Regional lymphadenectomy of at least 8 lymph nodes was necessary to stage patients accurately. Enough number lymph nodes examined was necessary for the clinicians to accurately predict the significance of LNR in resected pancreatic SRCC.

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Lymph Node Ratio as Valuable Predictor in Pancreatic Cancer Treated with R0 Resection and Adjuvant Treatment

Cited by 6 publications

References 0 publications

Lymph Node Ratio as a Prognostic Marker in Pancreatic Cancer Survival: A Systematic Review and Meta-Analysis

Lymph Node Ratio as a Prognostic Marker in Pancreatic Cancer Survival: A Systematic Review and Meta-Analysis

Lymph Node Subcapsular Sinus Microenvironment-On-A-Chip Modeling Shear Flow Relevant to Lymphatic Metastasis and Immune Cell Homing

The value of lymph node ratio and total number of lymph nodes examined for resected pancreatic signet ring cell carcinoma: a retrospective cohort study

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