Prognostic impact of the number of positive lymph nodes and lymph node ratio on the outcome of patients after resection of pancreatic adenocarcinoma

Stefan Kmezic; Dejan Radenkovic

Volume : VIII, Issue : VII, July - 2019

Prognostic impact of the number of positive lymph nodes and lymph node ratio on the outcome of patients after resection of pancreatic adenocarcinoma

Stefan Kmezic, Dejan Radenkovic

Abstract :

Introduction:. The presence of metastases in the lymph node in pancreatic adenocarcinoma is considered to be a factor that affects the survival of patients after resective surgery. The aim was to examine the effect of the number of positive lymph nodes and the lymph node ratio (LNR) on the outcome of patients after pancreatic carcinoma resection. Methods: A retrospective study was performed at the Department of Digestive Surgery, Clinical Center of Serbia, Belgrade, including 82 patients treated with radical surgery for pancreatic carcinoma (PC). Results: Negative lymph nodes had 28 patients, whereas 54 (65.5%) had positive lymph nodes. Median survival of all patients was 14 months. Patients with two or more metastatic lymph nodes had worse survival rate compared to patients with 0 or one lymph node (p=0.007), while individuals with LNR≥0.2 had worse outcome than patients with LNR<0.2 (p=0.049). According to our results factors associated with poorer survival were R1 surgical margin status (p=0.049) and the presence of 2 or more metastatic lymph nodes (p=0.015). Independent predictor of survival rate in our study were presence of ≥ 2 metastatic lymph nodes in patients with PC (p=0.026). Conclusion: The number of positive lymph nodes is more important prognostic factor than LNR in patients with resection of pancreatic carcinoma. Patients with two or more positive lymph nodes had a significantly shorter survival than those without positive or with one positive lymph node.