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Prognostic Implication of pN Stage Subdivision Using Metastatic Lymph Node Ratio in Resected Pancreatic Ductal Adenocarcinoma.

Authors
  • Pyo, Jung-Soo1
  • Kim, Nae Yu2
  • Son, Byoung Kwan3
  • Chung, Kwang Hyun3
  • 1 Department of Pathology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea. , (North Korea)
  • 2 Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea. , (North Korea)
  • 3 Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea. , (North Korea)
Type
Published Article
Journal
International journal of surgical pathology
Publication Date
Nov 05, 2019
Identifiers
DOI: 10.1177/1066896919886057
PMID: 31690145
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In this meta-analysis, we aimed to evaluate the prognostic implication of the metastatic lymph node ratio (mLNR) and its optimal criterion in pancreatic ductal adenocarcinoma (PDAC) with lymph node metastasis (LNM). The present study included 3735 patients with PDAC who had LNM, from 11 eligible studies. We carried out a meta-analysis to determine the correlation between a high mLNR and PDAC prognosis. The estimated mean numbers of examined and metastatic lymph nodes were 22.396 (95% confidence interval [CI] = 19.681-25.111) and 6.496 (95% CI = 4.646-8.345), respectively. A high mLNR was significantly correlated with worse overall survival (hazard ratio = 1.344, 95% CI = 1.276-1.416). In 3 subgroups based on high mLNR criteria (>0 and <0.2, ≥0.2 and <0.4, and ≥0.4), there were significant correlations between a high mLNR and worse survival. A cutoff of 0.200 showed the highest hazard ratio (1.391, 95% CI = 1.268-1.525), which was statistically significant. Our results showed that mLNR is a useful prognostic factor for PDAC with LNM. Although the optimal criterion of high mLNR may be 0.200, further cumulative studies are required before this can be applied in daily practice.

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