Journal article
Lymph node metastases in resected pancreatic ductal adenocarcinoma: predictors of disease recurrence and survival
British journal of cancer, Vol.117(12), pp.1874-1882
12/05/2017
DOI: 10.1038/bjc.2017.349
PMCID: PMC5729468
PMID: 28982112
Abstract
Background: Few studies have simultaneously assessed the prognostic value of the multiple classification systems for lymph node (LN) metastases in resected pancreatic ductal adenocarcinoma (PDAC).
Methods: In 600 patients with resected PDAC, we examined the association of LN parameters (AJCC 7th and 8th editions, LN ratio (LNR), and log odds of metastatic LN (LODDS)) with pattern of recurrence and patient survival using logistic regression and Cox proportional hazards regression, respectively. Regression models adjusted for age, sex, margin status, tumour grade, and perioperative therapy.
Results: Lymph node metastases classified by AJCC 7th and 8th editions, LNR, and LODDS were associated with worse disease freesurvival (DFS) and overall survival (OS) (all P-trend<0.01). American Joint Committee on Cancer 8th edition effectively predicted DFS and OS, while minimising model complexity. Lymph node metastases had weaker prognostic value in patients with positive margins and distal resections (both P-interaction<0.03). Lymph node metastases by AJCC 7th and 8th editions did not predict the likelihood of local disease as the first site of recurrence.
Conclusions: American Joint Committee on Cancer 8th edition LN classification is an effective and practical tool to predict outcomes in patients with resected PDAC. However, the prognostic value of LN metastases is attenuated in patients with positive resection margins and distal pancreatectomies.
Details
- Title: Subtitle
- Lymph node metastases in resected pancreatic ductal adenocarcinoma: predictors of disease recurrence and survival
- Creators
- Vicente Morales-Oyarvide - Dana-Farber Cancer InstituteDouglas A. Rubinson - Dana-Farber Cancer InstituteRichard F. Dunne - University of Rochester Medical CenterMargaret M. Kozak - Stanford UniversityJustin L. Bui - Stanford UniversityChen Yuan - Dana-Farber Cancer InstituteZhi Rong Qian - Dana-Farber Cancer InstituteAna Babic - Dana-Farber Cancer InstituteAnnacarolina Da Silva - Dana-Farber Cancer InstituteJonathan A. Nowak - Brigham and Women's HospitalNatalia Khalaf - Brigham and Women's HospitalLauren K. Brais - Dana-Farber Cancer InstituteMarisa W. Welch - Dana-Farber Cancer InstituteCaitlin L. Zellers - Dana-Farber Cancer InstituteKimmie Ng - Dana-Farber Cancer InstituteDaniel T. Chang - Stanford UniversityRebecca A. Miksad - Beth Israel Deaconess Medical CenterAndrea J. Bullock - Beth Israel Deaconess Medical CenterJennifer F. Tseng - Beth Israel Deaconess Medical CenterRichard S. Swanson - Brigham and Women's HospitalThomas E. Clancy - Brigham and Women's HospitalDavid C. Linehan - University of Rochester Medical CenterJennifer J. Findeis-Hosey - University of Rochester Medical CenterLeona A. Doyle - Brigham and Women's HospitalJason L. Hornick - Brigham and Women's HospitalShuji Ogino - Dana-Farber Cancer InstituteCharles S. Fuchs - Dana-Farber Cancer InstituteAram F. Hezel - University of Rochester Medical CenterAlbert C. Koong - The University of Texas MD Anderson Cancer CenterBrian M. Wolpin - Dana-Farber Cancer Institute
- Resource Type
- Journal article
- Publication Details
- British journal of cancer, Vol.117(12), pp.1874-1882
- DOI
- 10.1038/bjc.2017.349
- PMID
- 28982112
- PMCID
- PMC5729468
- NLM abbreviation
- Br J Cancer
- ISSN
- 0007-0920
- eISSN
- 1532-1827
- Publisher
- Springer Nature
- Number of pages
- 9
- Grant note
- K07 CA148894; R01 CA124908; P50 CA127003 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA U01 CA210171 / NIH/NCI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) CA130288 / Department of Defense; United States Department of Defense Noble Effort Fund Wexler Family Fund Lustgarten Foundation Perry S Levy Fund for Gastrointestinal Cancer Research Robert T and Judith B Hale Fund for Pancreatic Cancer UL1TR001863 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) Promises for Purple MyBlueDots Fund R35 CA197735 / NCI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) Pancreatic Cancer Action Network Pappas Family Research Fund for Pancreatic Cancer P50CA127003 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) Peter R Leavitt Family Fund
- Language
- English
- Date published
- 12/05/2017
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984313068202771
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