Prognostic relevance of lymph node status for patients with ampullary adenocarcinoma after radical resection followed by adjuvant treatment

J. Kwon, K. Kim, E. K. Chie, B. H. Kim, J. Y. Jang, S. W. Kim, D. Y. Oh, Y. J. Bang

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Purpose Attempts have been made to revise the nodal stage due to simplicity of current N staging system in ampullary adenocarcinoma. However, because of the disease rarity, there have only been a few studies assessing the prognostic impact of lymph node (LN) parameters. Methods We retrospectively analyzed 120 patients who underwent radical resection followed by adjuvant chemoradiotherapy for ampullary adenocarcinoma. The effect of LN parameters (number of total harvest LNs, number of metastatic LN (MLN), lymph node ratio (LNR), and log odds of positive LNs (LODDS)) on overall survival (OS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival were evaluated. Cutoff points of MLN, LNR and LODDs were determined using maximal χ2 method. Results Fifty-seven patients (48%) were staged as pN1 and their survival was not significantly decreased compared with pN0 patients. There was also no significant difference between patients with MLN 0 vs. 1. In univariate analyses, MLN (0–1 vs. ≥2), LNR (≤17% vs. >17%) and perineural invasion were common prognosticators for OS and LRFS. Distant metastasis-free survival was not influenced by LN status. In addition, multivariate analysis revealed that among the LN parameters, LNR was able to independently predict both OS and LRFS. Conclusions LNR performs better than other LN related parameters for predicting survival. After radical resection followed by adjuvant treatment, survival of patients with one positive LN does not seem to differ from patients without LN metastasis.

Original languageEnglish
Pages (from-to)1690-1696
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume43
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • Ampullary adenocarcinoma
  • Lymph node metastasis
  • Lymph node ratio
  • Number of metastatic lymph node

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