AI Article Synopsis
- The study investigates the impact of examined lymph nodes (ELN) on staging and survival in pancreatic ductal adenocarcinoma (PDAC).
- Analyzing data from 341 patients who underwent surgery, they found that examining at least 21 lymph nodes is crucial to accurately determine lymph node involvement.
- Failing to examine 21 or more lymph nodes may lead to misclassification, negatively affecting survival predictions for patients with PDAC.
Article Abstract
Background: The minimum number of examined lymph nodes (ELN) required for adequate staging and best prediction of survival has not been established in pancreatic ductal adenocarcinoma (PDAC). The aim of the study was to investigate the influence of ELN on staging and survival in PDAC.
Methods: Patients undergoing partial or total pancreatectomy for PDAC at two European university hospitals between 2007 and 2018 were retrospectively reviewed. Multivariate Cox regression model and survival analyses were performed to verify adequate staging.
Results: Overall 341 (73 per cent) patients showed lymph node metastasis (N1/N2), whereas 125 (27 per cent) patients had no lymph node involvement (N0). With increasing number of ELN, the proportion of positive lymph nodes increased. The minimum number of ELN needed to detect lymph node involvement was 21. In multivariate analysis, examination of <21 lymph nodes was a significant negative predictor for survival. Examination of ≥21 ELN reversed this effect and ruled out possible misclassification.
Conclusion: The number of ELN affects survival in PDAC. Possible misclassification was identified when <21 lymph nodes were examined. Therefore, at least 21 lymph nodes must be examined to avoid false lymph node classification in all types of resection.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810280 | PMC |
| http://dx.doi.org/10.1093/bjsopen/zrad125 | DOI Listing |
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