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The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection

BACKGROUND: Lymph node involvement is one of the well-demonstrated prognostic factors in ampullary carcinoma. The aim of this study is to clarify the role of lymph nodes in predicting the survival outcome of ampullary carcinoma. METHODS: A cohort of consecutive curative pancreaticoduodenectomies for...

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Autores principales: Chen, Shih-Chin, Shyr, Yi-Ming, Chou, Shu-Cheng, Wang, Shin-E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513626/
https://www.ncbi.nlm.nih.gov/pubmed/26205252
http://dx.doi.org/10.1186/s12957-015-0643-1
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author Chen, Shih-Chin
Shyr, Yi-Ming
Chou, Shu-Cheng
Wang, Shin-E
author_facet Chen, Shih-Chin
Shyr, Yi-Ming
Chou, Shu-Cheng
Wang, Shin-E
author_sort Chen, Shih-Chin
collection PubMed
description BACKGROUND: Lymph node involvement is one of the well-demonstrated prognostic factors in ampullary carcinoma. The aim of this study is to clarify the role of lymph nodes in predicting the survival outcome of ampullary carcinoma. METHODS: A cohort of consecutive curative pancreaticoduodenectomies for ampullary carcinoma from 1999 to 2014 was retrospectively analyzed. The effect of node-associated variables, including lymph node status, positive lymph node number, total harvested lymph node (THLN) number, and lymph node ratio (LNR) was examined using univariate and multivariate analyses for survival outcome prediction. RESULTS: In 194 evaluable patients, univariate analysis demonstrated that stage, cell differentiation, perineural invasion, and nodal status were significant conventional prognostic factors. Concerning the node-associated variables, positive nodal status, positive lymph node number ≥2, THLN number <14, and LNR ≥0.15 were significantly associated with poorer survival outcomes, with a 5-year survival rate of 20.3, 38.9, 25.4, and 18 %, respectively. By multivariate analysis, nodal status and THLN number were two independent predictors of survival. The most favorable 5-year survival rate was 84.4 % in patients with negative nodal involvement and THLN number ≥14, compared with the poorest 5-year survival rate of 16.1 % in those with positive nodal status and THLN number <14. CONCLUSIONS: Tumor biology reflected by lymph node status is the most important independent prognostic factor; nevertheless, surgical radicality based on THLN number also plays a significant role in the survival outcome for patients with ampullary carcinoma after curative pancreaticoduodenectomy.
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spelling pubmed-45136262015-07-25 The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection Chen, Shih-Chin Shyr, Yi-Ming Chou, Shu-Cheng Wang, Shin-E World J Surg Oncol Research BACKGROUND: Lymph node involvement is one of the well-demonstrated prognostic factors in ampullary carcinoma. The aim of this study is to clarify the role of lymph nodes in predicting the survival outcome of ampullary carcinoma. METHODS: A cohort of consecutive curative pancreaticoduodenectomies for ampullary carcinoma from 1999 to 2014 was retrospectively analyzed. The effect of node-associated variables, including lymph node status, positive lymph node number, total harvested lymph node (THLN) number, and lymph node ratio (LNR) was examined using univariate and multivariate analyses for survival outcome prediction. RESULTS: In 194 evaluable patients, univariate analysis demonstrated that stage, cell differentiation, perineural invasion, and nodal status were significant conventional prognostic factors. Concerning the node-associated variables, positive nodal status, positive lymph node number ≥2, THLN number <14, and LNR ≥0.15 were significantly associated with poorer survival outcomes, with a 5-year survival rate of 20.3, 38.9, 25.4, and 18 %, respectively. By multivariate analysis, nodal status and THLN number were two independent predictors of survival. The most favorable 5-year survival rate was 84.4 % in patients with negative nodal involvement and THLN number ≥14, compared with the poorest 5-year survival rate of 16.1 % in those with positive nodal status and THLN number <14. CONCLUSIONS: Tumor biology reflected by lymph node status is the most important independent prognostic factor; nevertheless, surgical radicality based on THLN number also plays a significant role in the survival outcome for patients with ampullary carcinoma after curative pancreaticoduodenectomy. BioMed Central 2015-07-25 /pmc/articles/PMC4513626/ /pubmed/26205252 http://dx.doi.org/10.1186/s12957-015-0643-1 Text en © Chen et. al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Chen, Shih-Chin
Shyr, Yi-Ming
Chou, Shu-Cheng
Wang, Shin-E
The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
title The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
title_full The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
title_fullStr The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
title_full_unstemmed The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
title_short The role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
title_sort role of lymph nodes in predicting the prognosis of ampullary carcinoma after curative resection
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513626/
https://www.ncbi.nlm.nih.gov/pubmed/26205252
http://dx.doi.org/10.1186/s12957-015-0643-1
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