The clinical significance of the lymph node ratio as a recurrence indicator in ampullary cancer after curative pancreaticoduodenectomy.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2024-10-08 DOI:10.1007/s00423-024-03481-y

Shinichiro Hasegawa, Hiroshi Wada, Masahiko Kubo, Yosuke Mukai, Manabu Mikamori, Hirofumi Akita, Norihiro Matsuura, Masatoshi Kitakaze, Yasunori Masuike, Takahito Sugase, Naoki Shinno, Takashi Kanemura, Hisashi Hara, Toshinori Sueda, Junichi Nishimura, Masayoshi Yasui, Takeshi Omori, Hiroshi Miyata, Masayuki Ohue

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引用次数: 0

Abstract

Background: The clinical significance of the lymph node ratio (LNR), the number of metastatic lymph nodes per dissected lymph node, has not been sufficiently clarified in ampullary cancer.

Methods: Among patients diagnosed histopathologically with ampullary cancer between 1980 and 2018, the study included 106 who underwent pathological radical resection by pancreaticoduodenectomy. The relationships between the LNR and metastatic lymph node sites and prognosis were examined.

Results: Multivariate analysis revealed that sex and lymph node metastasis were independent prognostic factors. In the 46 patients (43%) with metastatic lymph nodes, the LNR in the recurrence group was significantly higher than that in the non-recurrence group (0.15 ± 0.11 vs. 0.089 ± 0.071, p = 0.025). The receiver operating characteristic curve demonstrated that the LNR cut-off value, 0.07 (area under the curve = 0.70, sensitivity 81%, specificity 56%), was a significant indicator for recurrence (22% vs. 61%, p = 0.016) and prognosis (5-year survival: 48% vs. 83%, p = 0.028). Among the metastatic lymph node sites in the 46 positive cases, lymph node metastases developed from the peripancreatic head region (80%, 37/46) to the superior mesenteric artery (33%, 15/46) and para-aortic (11%, 5/46) regions.

Conclusion: Lymph node metastasis is an independent prognostic factor, and the LNR is a significant indicator for recurrence and prognosis in patients with ampullary cancer.

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淋巴结比值作为胰十二指肠切除术后复发指标的临床意义。

背景：淋巴结比率（LNR）是指每个切除淋巴结中转移淋巴结的数量：淋巴结比（LNR）是指每个切除淋巴结中转移淋巴结的数量，在胰壶腹癌中的临床意义尚未得到充分阐明：在1980年至2018年期间经组织病理学确诊的胰壶腹癌患者中，研究纳入了106名接受胰十二指肠切除术病理根治性切除的患者。研究了LNR和转移淋巴结部位与预后之间的关系：多变量分析显示，性别和淋巴结转移是独立的预后因素。在有淋巴结转移的 46 例患者（43%）中，复发组的 LNR 明显高于非复发组（0.15 ± 0.11 vs. 0.089 ± 0.071，P = 0.025）。接收器操作特征曲线显示，LNR 临界值 0.07（曲线下面积 = 0.70，敏感性 81%，特异性 56%）是复发（22% vs. 61%，p = 0.016）和预后（5 年生存率：48% vs. 83%，p = 0.028）的重要指标。在46例阳性病例的淋巴结转移部位中，淋巴结转移从胰头周围区域（80%，37/46）发展到肠系膜上动脉区域（33%，15/46）和主动脉旁区域（11%，5/46）：结论：淋巴结转移是一个独立的预后因素，淋巴结转移率是衡量胰腺癌患者复发和预后的重要指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.