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Does lymph node ratio impact survival in resected periampullary malignancies?
Michael G Hurtuk1, Christopher Hughes, Margo Shoup
1Department of Surgery, Division of Surgical Oncology, Loyola University Medical Center, Maywood, IL, USA.
American Journal of Surgery
|February 28, 2009
Summary
Lymph node ratio (LNR) impacts survival in periampullary malignancies. Higher LNR correlates with worse outcomes in pancreatic and ampullary adenocarcinoma, highlighting its prognostic value.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Lymph node ratio (LNR) is a known prognostic factor for pancreatic adenocarcinoma survival.
- Its association with survival in other periampullary malignancies remains underexplored.
Purpose of the Study:
- To investigate the association between lymph node ratio (LNR) and survival in patients with various periampullary malignancies.
Main Methods:
- Retrospective review of 522 pancreaticoduodenectomies (PDs) from 1988-2007.
- Clinicopathologic data and LNR were calculated for 364 identified malignancies.
- Patients with positive lymph node (LN) status were stratified by LNR: 0, ≤0.2, ≤0.4, and >0.4.
Main Results:
- The study included 219 pancreatic, 36 duodenal, 75 ampullary, and 35 cholangiocarcinomas.
- Positive LN status negatively impacted survival across all studied periampullary malignancies.
- Increasing LNR was significantly associated with decreased survival in pancreatic (P=.03) and ampullary adenocarcinoma (P=.04).
Conclusions:
- Positive lymph node status is linked to poorer survival in all periampullary malignancies.
- Lymph node ratio (LNR) demonstrates an inverse relationship with survival rates in pancreatic and ampullary adenocarcinoma.
