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Prognostic relevance of lymph node status for patients with ampullary adenocarcinoma after radical resection followed by adjuvant treatment

Title
Prognostic relevance of lymph node status for patients with ampullary adenocarcinoma after radical resection followed by adjuvant treatment
Authors
Kwon J.Kim K.Chie E.K.Kim B.H.Jang J.-Y.Kim S.W.Oh D.-Y.Bang Y.-J.
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2017
Journal Title
European Journal of Surgical Oncology
ISSN
0748-7983JCR Link
Citation
vol. 43, no. 9, pp. 1690 - 1696
Keywords
Ampullary adenocarcinomaLymph node metastasisLymph node ratioNumber of metastatic lymph node
Publisher
W.B. Saunders Ltd
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Purpose Attempts have been made to revise the nodal stage due to simplicity of current N staging system in ampullary adenocarcinoma. However, because of the disease rarity, there have only been a few studies assessing the prognostic impact of lymph node (LN) parameters. Methods We retrospectively analyzed 120 patients who underwent radical resection followed by adjuvant chemoradiotherapy for ampullary adenocarcinoma. The effect of LN parameters (number of total harvest LNs, number of metastatic LN (MLN), lymph node ratio (LNR), and log odds of positive LNs (LODDS)) on overall survival (OS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival were evaluated. Cutoff points of MLN, LNR and LODDs were determined using maximal χ2 method. Results Fifty-seven patients (48%) were staged as pN1 and their survival was not significantly decreased compared with pN0 patients. There was also no significant difference between patients with MLN 0 vs. 1. In univariate analyses, MLN (0–1 vs. ≥2), LNR (≤17% vs. >17%) and perineural invasion were common prognosticators for OS and LRFS. Distant metastasis-free survival was not influenced by LN status. In addition, multivariate analysis revealed that among the LN parameters, LNR was able to independently predict both OS and LRFS. Conclusions LNR performs better than other LN related parameters for predicting survival. After radical resection followed by adjuvant treatment, survival of patients with one positive LN does not seem to differ from patients without LN metastasis. © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
DOI
10.1016/j.ejso.2017.05.024
Appears in Collections:
의과대학 > 의학과 > Journal papers
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