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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 3/2008

01-05-2008 | Original Article

Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma

Authors: Peter Scheunemann, Nikolas H. Stoecklein, Alexander Rehders, Minu Bidde, Sylvia Metz, Matthias Peiper, Claus F. Eisenberger, Jan Schulte am Esch, Wolfram T. Knoefel, Stefan B. Hosch

Published in: Langenbeck's Archives of Surgery | Issue 3/2008

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Abstract

Background and aims

Occurrence of tumor relapse is frequent in patients with pancreatic cancer despite the absence of residual tumor detectable at primary surgery and in histopathological examination. Therefore, it has to be assumed that current tumor staging procedures fail to identify minimal amounts of disseminated tumor cells, which might be precursors of subsequent metastatic relapse. The aim of this study was to assess the prognostic impact of minimal tumor cell spread detected in lymph nodes classified as “tumor-free” in routine histopathologic evaluation.

Materials and methods

A total of 154 “tumor-free” lymph nodes from 59 patients with pancreatic cancer who underwent intentionally curative tumor resection were examined by immunohistochemistry for disseminated tumor cells.

Results

Fifty (32.5%) of the “tumor-free” lymph nodes obtained from 36 (61%) patients displayed disseminated tumor cells. Multivariate survival analysis revealed that the presence of disseminated tumor cells in “tumor-free” lymph nodes is an independent prognostic factor for both a significantly reduced relapse-free survival (p = 0.03) and overall survival (p = 0.02).

Conclusions

The frequent occurrence and prognostic impact of immunohistochemically identifiable disseminated tumor cells in lymph nodes of patients with operable pancreatic cancer supports the need for a refined staging system of excised lymph nodes, which should include immunohistochemical examination.
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Metadata
Title
Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma
Authors
Peter Scheunemann
Nikolas H. Stoecklein
Alexander Rehders
Minu Bidde
Sylvia Metz
Matthias Peiper
Claus F. Eisenberger
Jan Schulte am Esch
Wolfram T. Knoefel
Stefan B. Hosch
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 3/2008
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-007-0215-0

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