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Prognostic relevance of lymph node status for patients with ampullary adenocarcinoma after radical resection followed by adjuvant treatment

Cited 9 time in Web of Science Cited 9 time in Scopus
Authors
Kwon, J.; Kim, K.; Chie, E. K.; Kim, B. H.; Jang, J. -Y.; Kim, S. W.; Oh, D. -Y.; Bang, Yung-Jue
Issue Date
2017-09
Citation
European Journal of Surgical Oncology, Vol.43 No.9, pp.1690-1696
Keywords
Ampullary adenocarcinomaLymph node metastasisLymph node ratioNumber of metastatic lymph node
Abstract
Purpose: Attempts have been made to revise the nodal stage due to simplicity of current N staging system in ampullary adenocarcinoma. However, because of the disease rarity, there have only been a few studies assessing the prognostic impact of lymph node (LN) parameters. Methods: We retrospectively analyzed 120 patients who underwent radical resection followed by adjuvant chemoradiotherapy for ampullary adenocarcinoma. The effect of LN parameters (number of total harvest LNs, number of metastatic LN (MLN), lymph node ratio (LNR), and log odds 9f positive LNs (LODDS)). on overall survival (OS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival were evaluated. Cutoff points of MLN, LNR and LODDs were determined using maximal x2 method. Results: Fifty-seven patients (48%) were staged as pNl and their survival was not significantly decreased compared with pN0 patients. There was also no significant difference between patients with MLN 0 vs. 1. In univariate analyses, MLN (0-1 vs. >2), LNR (<17% vs. >17%) and perineural invasion were common prognosticators for OS and LRFS. Distant metastasis-free survival was not influenced by LN status. In addition, multivariate analysis revealed that among the LN parameters, LNR was able to independently predict both OS and LRFS. Conclusions: LNR performs better than other LN related parameters for predicting survival. After radical resection followed by adjuvant treatment, survival of patients with one positive LN does not seem to differ from patients without LN metastasis. (C) 2017 Elsevier Ltd, BASO- The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
ISSN
0748-7983
URI
https://hdl.handle.net/10371/173066
DOI
https://doi.org/10.1016/j.ejso.2017.05.024
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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