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Clinical Implication of Node-negative Resectable Pancreatic Cancer
Mihoko Yamada1, Teiichi Sugiura2, Yukiyasu Okamura1
1Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Annals of Surgical Oncology
|January 16, 2021
Summary
Pathologically node-negative pancreatic cancer (pN0-PC) has a better prognosis than node-positive disease, but survival is still unsatisfactory for many. Identifying risk factors in pN0-PC is crucial for improving patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Lymph node metastasis is a critical prognostic indicator in pancreatic cancer.
- The clinical significance of pathologically node-negative pancreatic cancer (pN0-PC) requires further investigation.
Purpose of the Study:
- To investigate the clinical implications and prognostic factors of pathologically node-negative pancreatic cancer (pN0-PC).
Main Methods:
- Retrospective analysis of 533 patients who underwent surgical resection for pancreatic cancer between 2002 and 2018.
- Clinicopathological examination focused on pN0-PC and identification of prognostic factors.
Main Results:
- 29.1% of patients were pN0-PC, with a 5-year survival rate of 57.1% compared to 25.0% for node-positive patients.
- Six prognostic factors for pN0-PC were identified: age ≥70, no adjuvant chemotherapy, serosal invasion, nerve plexus invasion, and lymphatic/venous invasion.
- Patients with 4-6 risk factors in pN0-PC had survival rates similar to node-positive patients.
Conclusions:
- While pN0-PC offers a better prognosis, it is not universally favorable.
- Risk stratification in pN0-PC is essential, as high-risk patients have poor survival outcomes.
- The diagnostic accuracy for metastasis-negative lymph nodes is limited.
