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