Evaluation of the prognostic factors and significance of lymph node status in invasive ductal carcinoma of the body or tail of the pancreas.
OBJECTIVE
We evaluated prognostic indicators for distal pancreatectomy with regional lymph node dissection in pancreatic body or tail carcinoma.


METHODS
Between 1993 and 2008, 50 patients with ductal carcinoma of the body or tail of the pancreas who underwent distal pancreatectomy with regional lymph node dissection were retrospectively analyzed. Clinicopathological factors associated with patient survival were evaluated.


RESULTS
No in-hospital deaths occurred among the study patients. The overall 5-year survival rate was 19.3%, and median survival was 22.6 months. Univariate analysis revealed that lymph node metastasis, intrapancreatic neural infiltration, peripancreatic nerve plexus infiltration, and tumor differentiation affected patient survival significantly. Multivariate analysis validated lymph node metastasis as an independent prognostic factor. Moreover, the lymph nodes attached to the pancreas were the most frequent metastatic nodes, and the number of metastasis in the lymph nodes attached to the pancreas was significantly associated with survival after surgical resection.


CONCLUSIONS
Lymph node metastasis was a significant and independent prognostic factor for the surgically resected pancreatic body or tail carcinoma. Furthermore, the lymph nodes attached to the pancreas were the most frequent metastatic nodes, and these lymph nodes were potential indicators predicting both tumor extension and survival after surgery for pancreatic body or tail carcinoma.
Fujita
Takeo
T
Division of Digestive Surgery, National Cancer Center Hospital East, Kashiwa, Japan. takfujit@east.ncc.go.jp
Nakagohri
Toshio
T
Gotohda
Naoto
N
Takahashi
Shinichiro
S
Konishi
Masaru
M
Kojima
Motohiro
M
Kinoshita
Taira
T
D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome