المؤلفون: Pierre Allemann, Jakob R. Izbicki, Markus Schäfer, Ismail Labgaa, Julie Perinel, Alessandro Zerbi, Mustapha Adham, Nicolas Demartines, Michael F. Nentwich, Dionisios Vrochides, Gaëtan-Romain Joliat, Gennaro Nappo, Jesse K Sulzer

المصدر: HPB, vol. 23, no. 3, pp. 379-386

مصطلحات موضوعية: medicine.medical_specialty, Pancreatic ductal adenocarcinoma, Hepatology, Tumor size, business.industry, Gastroenterology, Margins of Excision, Prognosis, Pancreatic head, Pancreatic Neoplasms, medicine.anatomical_structure, Internal medicine, Cohort, medicine, Resection margin, Humans, In patient, Lymph Nodes, Ductal adenocarcinoma, business, Lymph node, Carcinoma, Pancreatic Ductal, Retrospective Studies

الوصف: Background Resection margin status and lymph node (LN) involvement are known prognostic factors for patients who undergo pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC). This study aimed to compare overall survival (OS) and disease-free survival (DFS) by resection margin status in patients with PDAC and LN involvement. Methods A retrospective international multicentric study was performed including four Western centers. Multivariable Cox analysis was performed to identify prognostic factors of OS and DFS. Median OS and DFS were calculated using Kaplan–Meier curves and compared using log-rank tests. Results A cohort of 814 PDAC patients with pancreatoduodenectomy were analyzed. A total of 651 patients had LN involvement (80%). On multivariable analysis R1 resection was not an independent factor of worse OS and DFS in patients with LN involvement (HR 1.1, p = 0.565; HR 1.2, p = 0.174). Only tumor size, grade, and adjuvant chemotherapy were associated with OS and DFS. Median OS and DFS were similar between patients with R0 and R1 resections (23 vs. 20 months, p = 0.196; 15 vs. 14 months, p = 0.080). Conclusion Resection status was not identified as predictor of OS or DFS in PDAC patients with LN involvement. Extensive surgery to achieve R0 resection in such patients might not influence the disease course.

وصف الملف: application/pdf

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::29473be5dc10f629302e5be31c918a59
https://doi.org/10.1016/j.hpb.2020.07.008

المؤلفون: Jesse V. Groen, Nicolas Demartines, Markus Schäfer, Stijn van Roessel, Ismail Labgaa, J. Sven D. Mieog, Dionisios Vrochides, Marc G. Besselink, Julie Perinel, Alessandro Zerbi, Gennaro Nappo, Jesse K Sulzer, Gaëtan-Romain Joliat, Mustapha Adham

المصدر: Joliat, Gaëtan-Romain; Labgaa, Ismail; Sulzer, Jesse; Vrochides, Dionisios; Zerbi, Alessandro; Nappo, Gennaro; Perinel, Julie; Adham, Mustapha; van Roessel, Stijn; Besselink, Marc G.; Mieog, J. Sven D.; Groen, Jesse V.; Demartines, Nicolas; Schäfer, Markus (2021). International assessment and validation of the prognostic role of lymph node ratio in patients with resected pancreatic head ductal adenocarcinoma. Hepatobiliary surgery and nutrition AME Publishing Company 10.21037/hbsn-21-99 <http://dx.doi.org/10.21037/hbsn-21-99>
Hepatobiliary surgery and nutrition, vol. 11, no. 6, pp. 822-833
Hepatobiliary Surgery and Nutrition. AME PUBL CO
Hepatobiliary Surgery and Nutrition

مصطلحات موضوعية: medicine.medical_specialty, business.industry, lymphatic involvement, Pancreatic head, medicine.anatomical_structure, Pancreatectomy, cancer, medicine, General Earth and Planetary Sciences, In patient, Ductal adenocarcinoma, Radiology, business, Lymph node, General Environmental Science

الوصف: Lymph node ratio (LNR; positive/harvested lymph nodes) was identified as overall survival predictor in several cancers, including pancreatic adenocarcinoma. It remains unclear if LNR is predictive of overall survival in pancreatic adenocarcinoma patients staged pN2. This study assessed the prognostic overall survival role of LNR in pancreatic adenocarcinoma patients in relation with lymph node involvement. A retrospective international study in six different centers (Europe and United States) was performed. Pancreatic adenocarcinoma patients who underwent pancreatoduodenectomy from 2000 to 2017 were included. Patients with neoadjuvant treatment, metastases, R2 resections, or missing data regarding nodal status were excluded. Survival curves were calculated using Kaplan-Meier method and compared using log-rank test. Multivariable Cox regressions were performed to find independent overall survival predictors adjusted for potential confounders. A total of 1,327 patients were included. Lymph node involvement (pN+) was found in 1,026 patients (77%), 561 pN1 (55%) and 465 pN2 (45%). Median LNR in pN+ patients was 0.214 [interquartile range (IQR): 0.105-0.364]. On multivariable analysis, LNR was the strongest overall survival predictor in the entire cohort [hazard ratio (HR) =5.5; 95% confidence interval (CI): 3.1-9.9; P

وصف الملف: application/pdf

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::beb5c90740efd95782defbfa7b8e7341
https://pubmed.ncbi.nlm.nih.gov/36523941