title: Prognostic implications of lymph node metastases in carcinoma of the body and tail of the pancreas.
abstract: OBJECTIVE
  The current classification of pancreatic cancer is based only on anatomic location of metastatic lymph nodes (LNs). On the other hand, the number of metastatic LNs has been used in staging of colorectal, esophageal, and gastric cancers. The aim of this study was to assess the prognostic impact of the number or ratio of the metastatic LNs in pancreatic body and tail carcinoma.
  
  
  METHODS
  Eighty-five patients with pancreatic body and tail adenocarcinoma who underwent pancreatectomy were included. Location, number, ratio of metastatic LNs, and the survival of patients were analyzed.
  
  
  RESULTS
  Forty patients with LN metastasis had poor prognosis (P = 0.007). The prognoses of patients with 5 or more metastatic LNs were poorer than those with less than 5 metastatic LNs (P = 0.046), and patients with a metastatic LN ratio of 0.2 or more had the worst prognosis. Multivariate analysis revealed that 5 or more metastatic LNs and metastatic LN ratio of 0.2 or more were independent prognostic factors for survival (P = 0.0015 and P = 0.014, respectively).
  
  
  CONCLUSIONS
  These results indicate that the number and the ratio of metastatic LNs can be used to predict poor patient survival and as a staging strategy.
authors.affiliation: Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Tevfik T
authors.initials: TT
authors.lastname: Sahin
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Fujii
authors.forename: Mitsuro
authors.initials: M
authors.lastname: Kanda
authors.forename: Shunji
authors.initials: S
authors.lastname: Nagai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Kanzaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Kasuya
authors.forename: Shuji
authors.initials: S
authors.lastname: Nomoto
authors.forename: Shin
authors.initials: S
authors.lastname: Takeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome