Survival of patients with periampullary carcinoma is predicted by lymph node 8a but not by lymph node 16b1 status
Survival of patients with periampullary carcinoma is predicted by lymph node 8a but not by lymph node 16b1 status
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DOI：
10.1002/bjs.4761
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发表时间：
2004-12-01
影响因子：
9.6
通讯作者：
Neoptolemos, JP
中科院分区：
文献类型：
--
作者：
Connor, S;Bosonnet, L;Neoptolemos, JP
背景资料：本研究的目的是评估淋巴结8a和16 b1转移性疾病的影响。方法：从前瞻性数据库中识别因原发性胰腺导管腺癌或胰内胆管腺癌而接受切除术的患者结果：54例可评估患者中有13例发生8a淋巴结转移，44例有10例发生16 b1淋巴结转移。淋巴结8a转移性受累与中位生存期显著缩短相关（197 vs 470天; P 0.003），但淋巴结16 b1转移性受累不影响生存期（457 vs 503天; P 0.185）。多变量分析显示，淋巴结8a状态是最强的预后预测因子（P = 0.006）。8a淋巴结转移组与81例壶腹周围癌明显转移组的中位生存期无显著性差异（98 d; P = 0-072）。结论：8a淋巴结是壶腹周围癌患者的独立预后因素，而16 b1淋巴结不是。转移性淋巴结8a患者的生存率与就诊时有转移性疾病的患者无显著差异。术前确定淋巴结8a状态可能对选择患者进行治疗具有重要意义。
Background: The aim of this study was to assess the impact of metastatic disease in lymph nodes 8a and 16b1 (as defined by the Japanese Pancreas Society) on survival in patients with periampullary malignancy.Methods: Patients undergoing resection for primary pancreatic ductal adenocarcinoma or intrapancreatic bile duct adenocarcinoma were identified from a prospective database (September 1997-May 2003).Results: Thirteen of 54 and ten of 44 evaluable patients had metastatic involvement of lymph nodes 8a and 16b1 respectively. Metastatic involvement of lymph node 8a was associated with a significantly shorter median survival (197 versus 470 days; P 0.003) but metastatic involvement of lymph node 16b1 did not affect survival (457 versus 503 days; P 0.185). Multivariate analysis showed lymph node 8a status to be the strongest predictor of outcome (P = 0.006). Median survival of those with metastatic lymph node 8a was not significantly different from that of 81 patients with overt metastatic periampullary cancer at the time of diagnosis (98 days; P = 0-072)Conclusion: Lymph node 8a was an independent prognostic factor in patients with periampullary malignancy, but lymph node 16b1 was not. Survival in those with metastatic lymph node 8a was not significantly different from that in patients with metastatic disease at presentation. Preoperative determination of lymph node 8a status may have important implications in selecting patients for treatment.