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01-06-2013

Adequacy of Lymph Node Retrieval for Ampullary Cancer and Its Association with Improved Staging and Survival

Authors: Stefano Partelli, Stefano Crippa, Paola Capelli, Anna Neri, Claudio Bassi, Giuseppe Zamboni, Giuliano Barugola, Massimo Falconi

Published in: World Journal of Surgery | Issue 6/2013

Abstract

Background

The aim of the present study was to determine the optimal number of lymph nodes (LN) examined to stage pN0 tumors after surgery for ampulla of Vater carcinoma (AVC).

Methods

We reviewed retrospectively 127 patients with AVC who underwent pancreaticoduodenectomy (1990–2008). Univariate and multivariate analysis was performed.

Results

Fifty-nine patients (46.5 %) were pN0, whereas 68 patients (53.5 %) were pN1. The 5-year disease-specific survival (DSS) was worse for pN1 patients than for pN0 patients (46 vs. 77 %; P < 0.0001). In the pN0 cohort, the optimal cut-off number of LN analyzed was found to be 12. The 5-year DSS for patients with ≤12 LN was 50 %, compared with 89 % in those with >12 LN (P = 0.001). By multivariate analysis, a LN count >12 was the only independent predictor associated with improved survival (HR 0.16, P = 0.003) among pN0 patients. Among pN1 patients, a LN count >12 was associated with a significantly better 5-year DSS (59 vs. 22 %; P = 0.027). Patients with a lymph node ratio (LNR) >0.20 had a 5-year DSS of 24 %, compared with 58 % in those with 0 < LNR ≤ 0.20 (P = 0.038).

Conclusions

Removal of more than 12 LN for examination is associated with improved survival rate after surgery for AVC in both pN0 and pN1 patients.

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Title: Adequacy of Lymph Node Retrieval for Ampullary Cancer and Its Association with Improved Staging and Survival
Authors: Stefano Partelli
Stefano Crippa
Paola Capelli
Anna Neri
Claudio Bassi
Giuseppe Zamboni
Giuliano Barugola
Massimo Falconi
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 6/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-1995-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Adequacy of Lymph Node Retrieval for Ampullary Cancer and Its Association with Improved Staging and Survival

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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