The site of metastatic lymph node has prognostic significance in pancreatic ductal adenocarcinoma


Çağaptay S., Aysal Ağalar A., Ağalar C., Egeli T., Özbilgin M., Ünek T., ...Daha Fazla

34. Avrupa Patoloji Kongresi, Basel, İsviçre, 3 - 07 Eylül 2022, cilt.1, sa.481, ss.135

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 1
  • Basıldığı Şehir: Basel
  • Basıldığı Ülke: İsviçre
  • Sayfa Sayıları: ss.135
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Background & objectives: Pancreatic ductal adenocarcinomas

(PDAC) have poor survival rates and prognosis. Important prognostic

parameters are; tumour size/stage, metastatic lymph nodes count and

vascular invasion. In the current AJCC staging system, there is no recommendation

to specify metastatic regional lymph node localization.

Methods: Metastatic sites of 82 patients with regional lymph

node metastases out of 101 patients with PDAC who underwent

pancreaticoduodenectomy were classified as peripancreatic,

perigastric, hepatico-communis, hepatic pedicle and other

regions. Each region’s number of metastatic lymph nodes was

determined. The associations between the presence of metastases

in each lymph node region and overall survival and disease-free

survival were determined statistically.

Results: Eighty cases (79.2%) had peripancreatic, 7 cases (6.9%)

had perigastric, 6 cases (5.9%) had hepatico-communis, and 7 cases

(6.9%) had hepatic pedicle lymph node metastasis.

In survival analysis, the estimated overall and disease-free survival

time were significantly shorter in patients with hepatic pedicle

lymph node metastasis (35.5 vs 11.24 month; p= 0.001, 18.55

months/3.68 months; p <0.001, respectively). Although not significant,

the estimated overall survival time was shorter in patients

with hepaticocommunis lymph node metastasis (34.7 months/20.5

months; p= 0.32)

Hepatic pedicle lymph node metastasis was an independent predictor

of mortality (p=0.005) and recurrence (p=0.003) in multivariate

analysis.

Conclusion: The presence of hepatic pedicle lymph node

metastasis is an independent poor prognostic factor for mortality

and recurrence risk, according to our findings. Although not

significant, patients with hepaticocommunis lymph node metastasis

have 14-month shorter life expectancy than those without. With

these findings, we conclude that the metastatic lymph node site

may have an impact on the prognosis, and may be included in

pathology reports.