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The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas

Background and Objectives: Small bowel adenocarcinomas (SBAs) are rare tumors of the gastrointestinal system. Lymph node metastasis in patients with curatively resected SBAs is associated with poor prognosis. In this study, we determined the prognostic utility of the number of removed lymph nodes an...

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Autores principales: Aydin, Dincer, Kefeli, Umut, Ozcelik, Melike, Erdem, Gokmen Umut, Sendur, Mehmet Ali, Yildirim, Mahmut Emre, Oven, Basak Bala, Bilici, Ahmet, Gumus, Mahmut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456871/
https://www.ncbi.nlm.nih.gov/pubmed/37629761
http://dx.doi.org/10.3390/medicina59081472
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author Aydin, Dincer
Kefeli, Umut
Ozcelik, Melike
Erdem, Gokmen Umut
Sendur, Mehmet Ali
Yildirim, Mahmut Emre
Oven, Basak Bala
Bilici, Ahmet
Gumus, Mahmut
author_facet Aydin, Dincer
Kefeli, Umut
Ozcelik, Melike
Erdem, Gokmen Umut
Sendur, Mehmet Ali
Yildirim, Mahmut Emre
Oven, Basak Bala
Bilici, Ahmet
Gumus, Mahmut
author_sort Aydin, Dincer
collection PubMed
description Background and Objectives: Small bowel adenocarcinomas (SBAs) are rare tumors of the gastrointestinal system. Lymph node metastasis in patients with curatively resected SBAs is associated with poor prognosis. In this study, we determined the prognostic utility of the number of removed lymph nodes and the metastatic lymph node ratio (the N ratio). Materials and Methods: The data of 97 patients who underwent curative SBA resection in nine hospitals of Turkey were retrospectively evaluated. Univariate and multivariate analyses of potentially prognostic factors including the N ratio and the numbers of regional lymph nodes removed were evaluated. Results: Univariate analysis showed that perineural and vascular invasion, metastatic lymph nodes, advanced TNM stage, and a high N ratio were significant predictors of poor survival. Multivariate analysis revealed that the N ratio was a significant independent predictor of disease-specific survival (DSS). The group with the lowest N ratio exhibited the longest disease-free survival (DFS) and DSS; these decreased significantly as the N ratio increased (both, p < 0.001). There was no significant difference in either DFS or DSS between groups with low and high numbers of dissected lymph nodes (i.e., <13 and ≥13) (both, p = 0.075). Conclusions: We found that the N ratio was independently prognostic of DSS in patients with radically resected SBAs. The N ratio is a convenient and accurate measure of the severity of lymph node metastasis.
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spelling pubmed-104568712023-08-26 The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas Aydin, Dincer Kefeli, Umut Ozcelik, Melike Erdem, Gokmen Umut Sendur, Mehmet Ali Yildirim, Mahmut Emre Oven, Basak Bala Bilici, Ahmet Gumus, Mahmut Medicina (Kaunas) Article Background and Objectives: Small bowel adenocarcinomas (SBAs) are rare tumors of the gastrointestinal system. Lymph node metastasis in patients with curatively resected SBAs is associated with poor prognosis. In this study, we determined the prognostic utility of the number of removed lymph nodes and the metastatic lymph node ratio (the N ratio). Materials and Methods: The data of 97 patients who underwent curative SBA resection in nine hospitals of Turkey were retrospectively evaluated. Univariate and multivariate analyses of potentially prognostic factors including the N ratio and the numbers of regional lymph nodes removed were evaluated. Results: Univariate analysis showed that perineural and vascular invasion, metastatic lymph nodes, advanced TNM stage, and a high N ratio were significant predictors of poor survival. Multivariate analysis revealed that the N ratio was a significant independent predictor of disease-specific survival (DSS). The group with the lowest N ratio exhibited the longest disease-free survival (DFS) and DSS; these decreased significantly as the N ratio increased (both, p < 0.001). There was no significant difference in either DFS or DSS between groups with low and high numbers of dissected lymph nodes (i.e., <13 and ≥13) (both, p = 0.075). Conclusions: We found that the N ratio was independently prognostic of DSS in patients with radically resected SBAs. The N ratio is a convenient and accurate measure of the severity of lymph node metastasis. MDPI 2023-08-16 /pmc/articles/PMC10456871/ /pubmed/37629761 http://dx.doi.org/10.3390/medicina59081472 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Aydin, Dincer
Kefeli, Umut
Ozcelik, Melike
Erdem, Gokmen Umut
Sendur, Mehmet Ali
Yildirim, Mahmut Emre
Oven, Basak Bala
Bilici, Ahmet
Gumus, Mahmut
The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
title The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
title_full The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
title_fullStr The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
title_full_unstemmed The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
title_short The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
title_sort prognostic utility of the metastatic lymph node ratio and the number of regional lymph nodes removed from patients with small bowel adenocarcinomas
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456871/
https://www.ncbi.nlm.nih.gov/pubmed/37629761
http://dx.doi.org/10.3390/medicina59081472
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