Dissemin is shutting down on January 1st, 2025

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Springer Verlag, Journal of Hepato-Biliary-Pancreatic Sciences, 10(28), p. 893-901, 2021

DOI: 10.1002/jhbp.940

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Peritumoral lymph nodes in pancreatic cancer revisited; is it truly equivalent to lymph node metastasis?

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

AbstractBackgroundLymph node (LN) metastasis is a well‐known poor prognostic factor of pancreatic cancer. LN metastasis, through direct invasion of tumor cell to peritumoral lymph nodes (PTLN), is treated as the same as those which spread through lymphatic channels. This study aimed to evaluate the impact of PTLN invasion on the oncologic outcome of pancreatic cancer.MethodsFive hundred and six patients who underwent operation for pancreatic ductal adenocarcinoma from 2012 to 2018 were reviewed. PTLN invasion was defined as direct invasion of tumor cells in contact with main tumor.ResultsAmong the 506 patients, 112 patients (22.1%) had PTLN invasion. PTLN invasion group (PTLNI) showed better disease‐free survival than regional LN metastasis group (RLNM) and combined LN metastasis group (CLNM) (PTLNI 21 vs RLNM 11 vs CLNM 12 months, P = .003). There was no significant difference between N0 and PTLNI (PTLNI 21 vs N0 23 months, P = .999). In multivariate analysis, conventional LN metastasis was a significant factor compared to N0, but PTLN invasion was not (hazard ratio 0.786 [0.507‐1.220], P = .283).ConclusionBecause PTLN invasion does not adversely affect survival in the same way as LN metastasis does, pancreatic cancer–may be overstaged if PTLN invasion were dealt in the same manner as a metastatic LN. Therefore, PTLN invasion should be disregarded from current nodal staging system.