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Lymph node metastases in resected pancreatic ductal adenocarcinoma: predictors of disease recurrence and survival.
Morales-Oyarvide, Vicente; Rubinson, Douglas A; Dunne, Richard F; Kozak, Margaret M; Bui, Justin L; Yuan, Chen; Qian, Zhi Rong; Babic, Ana; Da Silva, Annacarolina; Nowak, Jonathan A; Khalaf, Natalia; Brais, Lauren K; Welch, Marisa W; Zellers, Caitlin L; Ng, Kimmie; Chang, Daniel T; Miksad, Rebecca A; Bullock, Andrea J; Tseng, Jennifer F; Swanson, Richard S; Clancy, Thomas E; Linehan, David C; Findeis-Hosey, Jennifer J; Doyle, Leona A; Hornick, Jason L; Ogino, Shuji; Fuchs, Charles S; Hezel, Aram F; Koong, Albert C; Wolpin, Brian M.
Afiliação
  • Morales-Oyarvide V; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Rubinson DA; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Dunne RF; Department of Medicine, Division of Hematology and Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
  • Kozak MM; Department of Radiation Oncology, Stanford Cancer Institute, 269 Campus Drive West, Stanford, CA 94305-5152, USA.
  • Bui JL; Department of Radiation Oncology, Stanford Cancer Institute, 269 Campus Drive West, Stanford, CA 94305-5152, USA.
  • Yuan C; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Qian ZR; Department of Epidemiology, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
  • Babic A; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Da Silva A; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Nowak JA; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Khalaf N; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
  • Brais LK; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
  • Welch MW; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Zellers CL; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Ng K; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Chang DT; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Miksad RA; Department of Radiation Oncology, Stanford Cancer Institute, 269 Campus Drive West, Stanford, CA 94305-5152, USA.
  • Bullock AJ; Department of Hematology and Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
  • Tseng JF; Department of Hematology and Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
  • Swanson RS; Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
  • Clancy TE; Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
  • Linehan DC; Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
  • Findeis-Hosey JJ; Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
  • Doyle LA; Department of Pathology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
  • Hornick JL; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
  • Ogino S; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
  • Fuchs CS; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
  • Hezel AF; Department of Epidemiology, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
  • Koong AC; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
  • Wolpin BM; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
Br J Cancer ; 117(12): 1874-1882, 2017 Dec 05.
Article em En | MEDLINE | ID: mdl-28982112
ABSTRACT

BACKGROUND:

Few studies have simultaneously assessed the prognostic value of the multiple classification systems for lymph node (LN) metastases in resected pancreatic ductal adenocarcinoma (PDAC).

METHODS:

In 600 patients with resected PDAC, we examined the association of LN parameters (AJCC 7th and 8th editions, LN ratio (LNR), and log odds of metastatic LN (LODDS)) with pattern of recurrence and patient survival using logistic regression and Cox proportional hazards regression, respectively. Regression models adjusted for age, sex, margin status, tumour grade, and perioperative therapy.

RESULTS:

Lymph node metastases classified by AJCC 7th and 8th editions, LNR, and LODDS were associated with worse disease free-survival (DFS) and overall survival (OS) (all Ptrend<0.01). American Joint Committee on Cancer 8th edition effectively predicted DFS and OS, while minimising model complexity. Lymph node metastases had weaker prognostic value in patients with positive margins and distal resections (both Pinteraction<0.03). Lymph node metastases by AJCC 7th and 8th editions did not predict the likelihood of local disease as the first site of recurrence.

CONCLUSIONS:

American Joint Committee on Cancer 8th edition LN classification is an effective and practical tool to predict outcomes in patients with resected PDAC. However, the prognostic value of LN metastases is attenuated in patients with positive resection margins and distal pancreatectomies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Carcinoma Ductal Pancreático / Excisão de Linfonodo / Linfonodos / Recidiva Local de Neoplasia Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Cancer Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Carcinoma Ductal Pancreático / Excisão de Linfonodo / Linfonodos / Recidiva Local de Neoplasia Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Cancer Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos