The clinical impact of the lymph node ratio as a prognostic factor after resection of pancreatic cancer.
BACKGROUND
The prognostic value of lymph node (LN) status in patients who underwent resection for pancreatic cancer (PC) was examined in the present study.


METHODS
Fifty-six patients who underwent macroscopic curative resection for PC were analyzed. Twelve factors, including the number of LN metastases, LN ratio, and N category according to the Japanese Pancreatic Society classification, were analyzed using univariate and multivariate analysis.


RESULTS
The optimal cut-off value was 0.2 for the LN ratio. Positive surgical margins (p=0.022) and LN ratio ≥0.2 (p=0.017) were identified as independent prognostic factors. Among the 33 patients with regional LN metastasis, patients with LN ratio ≥0.2 had significantly worse prognosis than those with LN ratio <0.2 (median survival time 14 vs. 26 months, p=0.048), however, the differences in survival between those with N1 and those with N2 by Japanese Pancreatic Society classification were not statistically significant (p=0.85).


CONCLUSIONS
The LN ratio might be more useful than other parameters as a predictor for survival after resection of PC.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku Kyoto 6028566, Japan. ikoma@koto.kpu-m.ac.jp.
Yusuke
Y
Yamamoto
Hisashi
H
Ikoma
Ryo
R
Morimura
Hirotaka
H
Konishi
Yasutoshi
Y
Murayama
Shuhei
S
Komatsu
Atsushi
A
Shiozaki
Yoshiaki
Y
Kuriu
Takeshi
T
Kubota
Masayoshi
M
Nakanishi
Daisuke
D
Ichikawa
Hitoshi
H
Fujiwara
Kazuma
K
Okamoto
Chouhei
C
Sakakura
Toshiya
T
Ochiai
Eigo
E
Otsuji
D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
Pancreatic cancer; lymph node metastasis; lymph node ratio; pancreatectomy