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Identification of an N staging system that predicts oncologic outcome in resected left-sided pancreatic cancer.

 Sung Hyun Kim  ;  Ho Kyoung Hwang  ;  Woo Jung Lee  ;  Chang Moo Kang 
 MEDICINE, Vol.95(26) : 4035, 2016 
Journal Title
Issue Date
Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging/methods ; Pancreatic Neoplasms/pathology* ; Pancreatic Neoplasms/surgery* ; Predictive Value of Tests ; Retrospective Studies ; Treatment Outcome
lymphatic metastasis ; neoplasm staging ; pancreatectomy ; pancreatic cancer ; survival
In this study, we investigated which N staging system was the most accurate at predicting survival in pancreatic cancer patients.Lymph node (LN) metastasis is known to be one of the important prognostic factors in resected pancreatic cancer. There are several LN evaluation systems to predict oncologic impact.From January 1992 to December 2014, 77 medical records of patients who underwent radical pancreatectomy for left-sided pancreatic cancer were reviewed retrospectively. Clinicopathologic variables including pN stage, total number of retrieved LNs (N-RLN), lymph node ratio (LNR), and absolute number of LN metastases (N-LNmet) were evaluated. Disease-free survival (DFS) and disease-specific survival (DSS) were analyzed according to these 4 LN staging systems.In univariate analysis, pN stage (pN0 vs pN1: 17.5 months vs 7.9 months, P = 0.001), LNR (<0.08 vs ≥0.08: 17.5 months vs 4.4 months, P < 0.001), and N-LNmet (#N = 0 vs #N = 1 vs #N≥2: 17.5 months vs 11.0 months vs 6.4 months, P = 0.002) had a significant effect on DFS, whereas the pN stage (pN0 vs pN1: 35.3 months vs 16.7 months, P = 0.001), LNR (<0.08 vs ≥0.08: 37.1 months vs 15.0 months, P < 0.001), and N-LNmet (#N = 0 vs #N = 1 vs #N≥2: 35.3 months vs 18.4 months vs 16.4 months, P = 0.001) had a significant effect on DSS. In multivariate analysis, N-LNmet (#N≥2) was identified as an independent prognostic factor of oncologic outcome (DFS and DSS: Exp (β) = 2.83, P = 0.001, and Exp (β) = 3.17, P = 0.001, respectively).Absolute number of lymph node metastases predicted oncologic outcome in resected left-sided pancreatic cancer patients.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Sung Hyun(김성현) ORCID logo https://orcid.org/0000-0001-7683-9687
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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