Prognosis Impact Of Lymph Node Metastasis In Pancreatic Cancer

Objective: To explore the prognosis impact of lymph node (LN) metastasis inpancreatic cancer.Methods: Clinical data of61patients with pancreatic cancer who underwentpancreaticoduodenectomy from January2004to September2011were analyzedretrospectively. Patients were categorized into groups by lymph node status(N1/N0),total count of lymph node detected, count of positive lymph node, location of positivelymph node, and lymph node ratio(LNR) respectively. Kaplan-Meier and Coxproportional hazard models were used to evaluate the prognostic effect.Results: Median survival for the overall61patients was13months(95%CI9.158~16.842months), with6-month,1-,3-,5-year survival rates of84.6%,47.7%,14.3%and9.1%, respectively. Following the univariate analysis: Patients with (pN1,n=37, median survival9months) and without (pN0, n=24, median survival19months)lymph node metastasis had a statistical significant outcome(P=0.001). Patients withinthe first station LN metastasis had a better outcome than whose LN metastasis beyondthe first station(median survival11vs.7months, P=0.014). Patients with LNR≤0.2had better prognosis(median survival11vs.7months with LNR＞0.2; P=0.005). Thenumber of lymph nodes examined had no effect on overall survival in eithernode-positive patients or node-negative patients (P＞0.05). The count of positivelymph node does not affect the prognosis in the pN1pantients. Following multivariateanalysis, positive LN status, positive LN location beyond the first station, and LNR＞0.2were independent predictors of a poor outcome.Conclusions: LN metastasis status has significant effect on the prognosis of thepancreatic cancer. Location of positive LN and LNR are independent predictors of theprognosis in the pN1patients. The number of LNs examined and the number ofpositive LNs had no effect on the prognosis in the pancreatic cancer.