N0/N1, PNL, or LNR? The effect of lymph node number on accurate survival prediction in pancreatic ductal adenocarcinoma.
N0/N1, PNL, or LNR? The effect of lymph node number on accurate survival prediction in pancreatic ductal adenocarcinoma.
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DOI：
10.1007/s11605-012-1974-7
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发表时间：
2013-02
影响因子：
3.2
通讯作者：
Thayer, Sarah P.
中科院分区：
文献类型：
--
作者：
Valsangkar, Nakul P.;Bush, Devon M.;Michaelson, James S.;Ferrone, Cristina R.;Wargo, Jennifer A.;Lillemoe, Keith D.;Fernandez-del Castillo, Carlos;Warshaw, Andrew L.;Thayer, Sarah P.
我们在检查淋巴结总数（ELN）的背景下评估了LN变量（N 0/N1）、阳性淋巴结数量（PLN）和淋巴结比率（LNR）的预后准确性。对来自SEER和单一机构（MGH）的患者进行了审查，并根据ELN数量在亚组中进行了生存分析，以计算超额死亡风险（风险比，HR）。在SEER和MGH中，ELN数量越多，N 0患者的总生存率越高。预后意义（N 0/N1）和PLN变化太大，因为单个PLN的重要性取决于切除的LN总数。一旦切除一定数量的淋巴结（SEER中≥13，MGH数据集中≥17），LNR始终与生存相关。随着ELN增加，N 0患者的生存率更高可能代表分期改善。PLN有一定的预测价值，但ELN强烈影响其对生存的影响，这表明需要一个基于比率的分类。只要对一定数量的淋巴结进行评估，LNR与预后密切相关，这表明任何LN变量的预后准确性取决于ELN的总数。
We evaluated the prognostic accuracy of LN variables (N0/N1), numbers of positive lymph nodes (PLN), and lymph node ratio (LNR) in the context of the total number of examined lymph nodes (ELN). Patients from SEER and a single institution (MGH) were reviewed and survival analyses performed in subgroups based on numbers of ELN to calculate excess risk of death (hazard ratio, HR). In SEER and MGH, higher numbers of ELN improved the overall survival for N0 patients. The prognostic significance (N0/N1) and PLN were too variable as the importance of a single PLN depended on the total number of LN dissected. LNR consistently correlated with survival once a certain number of lymph nodes were dissected (≥13 in SEER and ≥17 in the MGH dataset). Better survival for N0 patients with increasing ELN likely represents improved staging. PLN have some predictive value but the ELN strongly influence their impact on survival, suggesting the need for a ratio-based classification. LNR strongly correlates with outcome provided that a certain number of lymph nodes is evaluated, suggesting that the prognostic accuracy of any LN variable depends on the total number of ELN.
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影响因子：
3.2
作者：
Fernandez-Cruz, Laureano;Cosa, Rebeca;Navarro, Salvador
通讯作者：
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影响因子：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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