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01-11-2012 | Original Article

A High Positive Lymph Node Ratio is Associated with Distant Recurrence after Surgical Resection of Ampullary Carcinoma

Authors: Christina L. Roland, Matthew H. G. Katz, Graciela M. N. Gonzalez, Peter W. T. Pisters, Jean-Nicolas Vauthey, Robert A. Wolff, Christopher H. Crane, Jeffrey E. Lee, Jason B. Fleming

Published in: Journal of Gastrointestinal Surgery | Issue 11/2012

Abstract

Background

For ampullary carcinoma (AC), the lymph node ratio (LNR) has been associated with overall survival. However, the use of the LNR to predict distant recurrence risk remains unknown. The purpose of this study was to determine if the LNR is associated with distant recurrence risk.

Methods

One hundred forty three patients with AC who underwent pancreaticoduodenectomy between 1989 and 2011 were identified from a single-institution prospective database. Data on clinicopathologic factors and recurrence were analyzed.

Results

At a median follow-up of 43 months (62 months for survivors), 55 patients (38 %) had developed recurrent disease, with a median time to recurrence of 13 months. Patients with a LNR ≥0.15 were more likely to have T3/4 tumors, advanced stage lymphovascular (LVI), or perineural invasion (PNI) and develop recurrent disease. Univariate analysis demonstrated that T-stage, lymph node status, AJCC stage, LVI, PNI, and LNR were significantly associated with decreased time to distant recurrence (TTDR). In multivariate stepwise regression, only LNR and LVI were significantly associated with decreased TTDR.

Conclusions

A high positive LNR is associated with distant recurrence after surgical resection of AC. Given the high risk of disease recurrence, consideration for adjuvant therapy is warranted in patients with a LNR ≥0.15.

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Title: A High Positive Lymph Node Ratio is Associated with Distant Recurrence after Surgical Resection of Ampullary Carcinoma
Authors: Christina L. Roland
Matthew H. G. Katz
Graciela M. N. Gonzalez
Peter W. T. Pisters
Jean-Nicolas Vauthey
Robert A. Wolff
Christopher H. Crane
Jeffrey E. Lee
Jason B. Fleming
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 11/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-012-2015-2

At a glance: The STEP trials

Springer Medicine

A High Positive Lymph Node Ratio is Associated with Distant Recurrence after Surgical Resection of Ampullary Carcinoma

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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