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01-11-2008 | Hepatic and Pancreatic Tumors

Prognostic Relevance of Lymph Node Ratio and Number of Resected Nodes after Curative Resection of Ampulla of Vater Carcinoma

Authors: Massimo Falconi, MD, Stefano Crippa, MD, Ismael Domínguez, MD, Giuliano Barugola, MD, Paola Capelli, MD, Stefano Marcucci, MD, Stefania Beghelli, MD, Aldo Scarpa, MD, Claudio Bassi, MD, Paolo Pederzoli, MD

Published in: Annals of Surgical Oncology | Issue 11/2008

Abstract

Background

Nodal metastasis is considered a major prognostic factor in patients with ampulla of Vater carcinoma (AVC). No study has investigated the significance of the ratio between metastatic and resected/examined lymph nodes (LNR) in patients with AVC.

Methods

Demographic, operative, and pathology data, including number of resected/evaluated nodes and LNR, were collected from patients who underwent pancreaticoduodenectomy with radical intent for invasive AVC from 1990 to 2005. Survival rates and recurrence patterns were evaluated and predictors were identified.

Results

In 90 evaluable patients (51 males, 39 females, median age 62.5 years), 5-year disease-specific survival (DSS) was 61%. The median number of resected/evaluated nodes was 16 (range: 5–47); 50% of the patients had nodal metastases. The 5-year DSS according to LNR was 75%, 49%, 38%, and 0% for LNR = 0, LNR >0 and ≤0.2, LNR >0.2, and ≤0.4, and LNR >0.4 (P = 0.002), respectively. The 5-year DSS was 81% in patients with >16 resected/evaluated nodes compared with 45% in those with ≤16 resected/evaluated nodes (P = 0.001). On multivariate analysis LNR and a number of resected/evaluated nodes >16 were significant predictors of survival; a number of resected/evaluated nodes >16 was also the only independent predictor of recurrence.

Conclusions

After curative resection for AVC, LNR and a cutoff of 16 resected/evaluated nodes are powerful prognostic factors. LNR might represent a major parameter for patient stratification in adjuvant treatment trials.

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Title: Prognostic Relevance of Lymph Node Ratio and Number of Resected Nodes after Curative Resection of Ampulla of Vater Carcinoma
Authors: Massimo Falconi, MD
Stefano Crippa, MD
Ismael Domínguez, MD
Giuliano Barugola, MD
Paola Capelli, MD
Stefano Marcucci, MD
Stefania Beghelli, MD
Aldo Scarpa, MD
Claudio Bassi, MD
Paolo Pederzoli, MD
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-008-0099-4

At a glance: The STEP trials

Springer Medicine

Prognostic Relevance of Lymph Node Ratio and Number of Resected Nodes after Curative Resection of Ampulla of Vater Carcinoma

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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