Universität zu Köln

Prenzel, Klaus L., Hoelscher, Arnulf H., Drebber, Uta, Bollschweiler, Elfriede, Gutschow, Christian A., Stippel, Dirk L. and Moenig, Stefan P. (2014). Extracapsular Lymph Node Spread as a Negative Prognostic Factor of Adenocarcinoma of the Pancreas and Cancer of the Papilla of Vater. Pancreas, 43 (1). S. 64 - 69. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4828

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Abstract

Objective The aim of this study was to analyze the incidence and impact of extracapsular lymph node spread (ELNS) in pancreatic cancer (PC) and cancer of the papilla of Vater (CPV). Methods Between 2004 and 2009, 148 patients underwent surgical therapy for PC (n = 112) and CPV (n = 36). The resected lymph nodes (LNs) were further analyzed for ELNS. Results In 95 (64.2%) patients, LN metastasis was present. In 45 (47.3%) of these patients, an ELNS was present on histopathology. The patients' survival was negatively affected by ELNS. For PC, the 5-year survival rate was 37% for patients with no LN metastasis compared with 4% and 0% for patients with LN metastasis (pN1) but without extracapsular LN involvement and patients with pN1 disease with extracapsular LN involvement of at least 1 LN, respectively (P < 0.001). In patients with CPV, the 5-year survival rate was 56% for patients with no LN metastasis and 44% and 0% for patients with pN1 disease but without extracapsular LN involvement and patients with pN1 disease with extracapsular LN involvement of at least 1 LN, respectively (P = 0.006). Multivariate analysis revealed ELNS as an independent prognostic factor of survival for both tumor types. Conclusions Extracapsular LN spread is an independent negative prognostic factor in PC and CPV. In future staging systems, ELNS should be included.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Prenzel, Klaus L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Drebber, Uta UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, Christian A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stippel, Dirk L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenig, Stefan P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-452633
DOI:	10.1097/MPA.0b013e3182a44a91
Journal or Publication Title:	Pancreas
Volume:	43
Number:	1
Page Range:	S. 64 - 69
Date:	2014
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4828
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTENDED RETROPERITONEAL LYMPHADENECTOMY; SQUAMOUS-CELL CARCINOMA; PERIAMPULLARY ADENOCARCINOMA; AMPULLARY CARCINOMA; GASTRIC-CANCER; RISK-FACTOR; PANCREATICODUODENECTOMY; SURVIVAL; INVOLVEMENT; METASTASIS Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/45263