Pancreatic cancer patients with lymph node involvement by direct tumor extension have similar survival to those with node‐negative disease

Williams, Jennifer L.; Nguyen, Andrew H.; Rochefort, Matthew M.; Muthusamy, V. Raman; Wainberg, Zev A.; Dawson, David W.; Tomlinson, James S.; Hines, Oscar J.; Reber, Howard A.; Donahue, Timothy R.

doi:10.1002/jso.24011

Cited by 15 publications

(31 citation statements)

References 17 publications

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“…Since lymph node metastasis is a prognostic factor for surgical extirpation of the primary tumor and metastatic tissues [23], the expression of Kaiso in tumors of patients with lymph node metastases was analyzed (Stage N). Tissue specimens of female patients with lymph node metastases (N11–N3), showed higher cytoplasmic Kaiso (n = 30; P < 0.0001) than those with no lymph node metastasis (N0) (n-18) (Fig.…”

Section: Resultsmentioning

confidence: 99%

African Americans with pancreatic ductal adenocarcinoma exhibit gender differences in Kaiso expression

et al. 2016

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Kaiso, a bi-modal transcription factor, regulates gene expression, and is elevated in breast, prostate, and colon cancers. Depletion of Kaiso in other cancer types leads to a reduction in markers for the epithelial–mesenchymal transition (EMT) (Jones et al., 2014), however its clinical implications in pancreatic ductal adenocarcinoma (PDCA) have not been widely explored. PDCA is rarely detected at an early stage but is characterized by rapid progression and invasiveness. We now report the significance of the subcellular localization of Kaiso in PDCAs from African Americans. Kaiso expression is higher in the cytoplasm of invasive and metastatic pancreatic cancers. In males, cytoplasmic expression of Kaiso correlates with cancer grade and lymph node positivity. In male and female patients, cytoplasmic Kaiso expression correlates with invasiveness. Also, nuclear expression of Kaiso increases with increased invasiveness and lymph node positivity. Further, analysis of the largest PDCA dataset available on ONCOMINE shows that as Kaiso increases, there is an overall increase in Zeb1, which is the inverse for E-cadherin. Hence, these findings suggest a role for Kaiso in the progression of PDCAs, involving the EMT markers, E-cadherin and Zeb1.

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Section: Resultsmentioning

confidence: 99%

African Americans with pancreatic ductal adenocarcinoma exhibit gender differences in Kaiso expression

et al. 2016

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“…However, it was limited by having only 14 PTLNI patients. 27 In a Japanese single institution study of 98 PDAC patients, PTLNI was found in 27 patients (27.6%). 28 They reported that there was no statistically significant difference in survival outcomes between patients with PTLNI and patients without LN metastasis.…”

Section: Discussionmentioning

confidence: 98%

“…Several studies have investigated the effect of PTLN invasion on the prognostic outcome. [24][25][26][27][28] The first study in the literature on PTLN was published in 2010 by Massachusetts General Hospital group. 24 They reviewed 517 patients who underwent pancreatic resection for PDAC and found direct invasion in at least 20% of patients with one or two LN metastases.…”

Section: Discussionmentioning

confidence: 99%

Peritumoral lymph nodes in pancreatic cancer revisited; is it truly equivalent to lymph node metastasis?

Byun

Lee

Jang

et al. 2021

J Hepato Biliary Pancreat

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Pancreatic cancer is well-known for its devastating survival outcomes. Recently released statistics in the United States show that it is the 4th leading cause of cancer death in both males and females. 1,2 One of the major reasons for such an outcome is its tendency for early metastasis through lymphatic drainage. 3,4 Many studies have demonstrated the adverse effect of lymph node (LN) metastasis. [5][6][7][8][9] Thus, the importance of accurately reporting the LN status cannot be overemphasized for proper staging and more accurate prognosis prediction. 10,11 Various methods have been proposed in reporting LN status including simple presence of LN metastasis, number of metastatic LNs, LN ratio, and log odds of positive LNs. [9][10][11][12][13][14][15][16][17]

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“…Regarding the extremely small metastatic deposits in the LN of the pancreatic cancer, several studies define “micrometastasis” as a single cell or a small clusters of tumor cells in LNs that remain undetected by the routine histopathological staining techniques, but can be detected by immunohistochemical (IHC) or molecular techniques such as epithelial cell adhesion molecule (EpCAM/Ber-EP4), [7,14,23] cytokeratin staining, [18,19,21] CK-19 staining, [20,22] and polymerase chain reaction for mutant K-RAS [15,25,27] (Table 4). On the other hand, the UICC TNM Classification defines “micrometastasis” as a lesion of size 0.2 mm to 0.2 cm and an ITC as a lesion of size < 0.2 mm.…”

Section: Discussionmentioning

confidence: 99%

Pathomorphological features of metastatic lymph nodes as predictors of postoperative prognosis in pancreatic cancer

et al. 2019

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To investigate the pathological features of metastatic lymph nodes (LN) in pancreatic ductal adenocarcinoma (PDAC) and to determine factors with prognostic implications. Metastatic LN status is a proven significant factor for predicting postoperative prognosis in pancreatic cancer patients. However, the effective prognostic criteria regarding metastatic LNs for such disease remain unknown. We retrospectively reviewed 98 patients with R0/1 resection for PDAC. All metastatic LNs were evaluated for the pathomorphological features of metastasis and analyzed in terms of postoperative outcomes. Various morphological patterns of metastasis were assessed in 440 positive LNs and then classified into 4 groups: common type, direct type (continuously invaded by the main tumor), scatter type (multiple tumor clusters among the normal LN tissues), and isolated tumor cell (ITC). The pathological stage was defined as stage IIA in 10% and IIB in 90% patients. Common-type metastasis was noted in 55% positive LNs of 75% node-positive patients; direct type in 36% LNs of 69% patients; scatter type in 5% LNs of 14% patients; and ITCs in 5% LNs of 18% patients. Significant difference was noted only in recurrence-free survival (RFS) but not in overall survival (OS) in the common-type; only in OS but not in RFS for the scatter type; and neither in RFS nor OS for both direct type and ITC. Multivariate analysis revealed that only LN ratio and curability were independent predictive factors of poor. The tumor distribution patterns in metastatic LNs are the postoperative prognostic factors in pancreatic cancer.

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Pancreatic cancer patients with lymph node involvement by direct tumor extension have similar survival to those with node‐negative disease

Abstract: The mechanism of LN involvement affects PDAC prognosis. Patients with LNs involved by direct extension have similar survival to those with node-negative disease.

Cited by 15 publications

References 17 publications

African Americans with pancreatic ductal adenocarcinoma exhibit gender differences in Kaiso expression

African Americans with pancreatic ductal adenocarcinoma exhibit gender differences in Kaiso expression

Peritumoral lymph nodes in pancreatic cancer revisited; is it truly equivalent to lymph node metastasis?

Pathomorphological features of metastatic lymph nodes as predictors of postoperative prognosis in pancreatic cancer

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