Log Odds of Positive Lymph Nodes Predicts the Survival in Resectable Pancreatic Adenocarcinoma

11th International Gastrointestinal Cancers Conference, İstanbul, Türkiye, 2 - 05 Aralık 2021, ss.28, (Özet Bildiri)

Yayın Türü: Bildiri / Özet Bildiri
Basıldığı Şehir: İstanbul
Basıldığı Ülke: Türkiye
Sayfa Sayıları: ss.28
Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Introduction: Lymph node metastasis is an important prognostic factor in pancreatic adenocarcinoma. Log odds of positive lymph nodes (LODDS) is a novel prognostic indicator on lymph node status. In the last decade, some articles reporting that LODDS is effective in predicting prognosis in various cancer types, have been published. We aimed to evaluate the prognostic impact of LODDS for the patients with pancreatic adenocarcinoma who underwent R0 pancreaticoduodenectomy. Material-Method: Standard pancreaticoduodenectomy and standard LN dissection (LN regions 3, 4, 5, 6, 8a, 12b1, 12b2, 12c, 13a, 13b,14a, 14b,17a, and 17b) were performed for all cases. Demographics of the patients, presentation symptoms, operation data, histopathological features of tumors, status of surgical margins, harvested total LN count, metastatic LN count, perioperative morbidity and mortality, and oncological follow up were analyzed from the prospectively collected database of our institution and pathology reports. Survival status and death dates of the patients were obtained from the national population registry system and the hospital registry system. LODDS was calculated as (number of metastatic lymph nodes + 0.5) / (number of total harvested nodes - metastatic lymph nodes + 0.5), 0.5 is added to both numerator and denominator to avoid singularity. LODDS subgroups were created as in previous studies according to LODDS value. LODDS1 (LODDS? ? 1.5), LODDS2 (?1.5 < LODDS? ? 1.0), LODDS3 (?1.0 ?0.5). Overall survival was calculated as elapsed time from the operation date to time of death. Kaplan - Meier (K-M) estimator was used to calculate the OS rates; Log - rank test was used to compare differences between survival curves. Results: Fifty-five patients with a mean age of 64.85±11.3 (36-90 years) who underwent R0 pancreaticoduodenectomy between 2010 and 2017 were included. Of the patients, 39 (71%) were male and 16 (29%) were female. The mean number of harvested lymph nodes was 23.8±12.5, the mean number of metastatic lymph nodes was 2.53±2.6. The mean follow-up period and the mean survival time of the patients was 34.7±31.3 and 38.1±5.1 months respectively. 87% of the patients died during the follow-up period. Survival rates for 1, 3 and 5 years were 72%, 38%and 16%, respectively The mean LODDS value was ?0.9727± 0.529. 12 patients (21.8%) were classified into LODDS 1, 13 patients (23.6%) into LODDS 2, 18 patients (32.7%) into LODDS 3, and 12 patients (21.8%) into LODDS 4 group. LODDS subgroups showed correlation with overall survival, the mean survival were 65.1, 31.8, 32.0 and 20.6 months in LODDS subgroups 1, 2, 3 and 4, respectively (Log-rank; p = 0.033). Conclusion: In parallel with the literature, our findings support that, analyzing the lymph nodes with LODDS method predicts the overall survival in patients with pancreatic adenocarcinoma.

Keywords: pancreas adenocarcinoma, LODDS, log odds