Woohyung Lee, Jeein Park, Aram Shin, Mirang Lee, Min Kyu Sung, Kwangpyo Hong, Yejong Park, Ki Byung Song, Jae Hoon Lee, Dae Wook Hwang, Song Cheol Kim
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引用次数: 0
Abstract
Background: The prognostic value of nodal staging in patients undergoing surgery for borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) remains unclear. This study evaluated a novel system based on metastatic lymph nodes (nMLN).
Methods: Patients who underwent surgery were categorized into upfront surgery (UP) and neoadjuvant chemotherapy (NAT) groups. In the NAT group, the nMLN system was developed using K-adaptive partitioning, classifying patients by the number of metastatic lymph nodes (nMLN0: 0; nMLN1: 1-4; nMLN2: ≥5). Prognostic performance was compared between the nMLN and AJCC 8th edition systems using time-dependent area under the curve (AUC) analyses.
Results: A total of 730 UP and 347 NAT patients were included. Compared to the UP group, the NAT group had fewer N1 cases (P = 0.032) and less lymphovascular invasion (P < 0.001). The nMLN system significantly stratified overall survival (OS) and recurrence-free survival (RFS) in NAT (P < 0.001) and UP groups (P < 0.001). Prognostic performance was comparable between the nMLN and AJCC 8th systems for OS (AUC: 0.628 vs. 0.629) and RFS (AUC: 0.643 vs. 0.649).
Conclusion: Both the nMLN and AJCC 8th staging systems provide effective prognostic stratification and are applicable in NAT and UP settings.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
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HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
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