Pattern analysis of lymph node metastasis and the prognostic importance of number of metastatic nodes in ampullary adenocarcinoma

Jae Hoon Lee, Kyeong Geun Lee, Tae Kyung Ha, Young Jin Jun, Seung Sam Paik, Hwon Kyum Park, Kwang Soo Lee

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24 Citations (Scopus)

Abstract

The aims of this study were to clarify the distribution and spread pattern of metastatic nodes and to evaluate the importance of the number, ratio, and location of positive nodes in ampullary adenocarcinoma. We analyzed the clinicopathologic data and survival of 52 patients who received curative pancreatoduodenectomy for ampullary adenocarcinoma between June 1994 and May 2009. Metastatic lymph nodes were found in 32 (61.5%) patients. The median number of evaluated nodes and positive nodes were 26 (range 10-60) and two (range 1-15), respectively. The most commonly involved nodes were the posterior pancreaticoduodenal nodes (26 patients) followed by the anterior pancreaticoduodenal nodes (11 patients). No positive hepatoduodenal and common hepatic artery nodeswere found. In univariate analysis, number of positive nodes, and their ratio and locationwere significantly associated with survival. Only the factor of three or more metastatic nodes had the independent power in predicting a poor outcome in multivariate analysis (P < 0.001). Ampullary adenocarcinoma first spreads to the posterior pancreaticoduodenal nodes and then the anterior nodes. The number of positive lymph nodes, rather than their ratio and location, independently affects survival after curative resection in patients with ampullary carcinoma.

Original languageEnglish
Pages (from-to)322-329
Number of pages8
JournalAmerican Surgeon
Volume77
Issue number3
StatePublished - 2011 Mar 1

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Adenocarcinoma
Lymph Nodes
Neoplasm Metastasis
Survival
Pancreaticoduodenectomy
Hepatic Artery
Multivariate Analysis
Carcinoma

Cite this

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title = "Pattern analysis of lymph node metastasis and the prognostic importance of number of metastatic nodes in ampullary adenocarcinoma",
abstract = "The aims of this study were to clarify the distribution and spread pattern of metastatic nodes and to evaluate the importance of the number, ratio, and location of positive nodes in ampullary adenocarcinoma. We analyzed the clinicopathologic data and survival of 52 patients who received curative pancreatoduodenectomy for ampullary adenocarcinoma between June 1994 and May 2009. Metastatic lymph nodes were found in 32 (61.5{\%}) patients. The median number of evaluated nodes and positive nodes were 26 (range 10-60) and two (range 1-15), respectively. The most commonly involved nodes were the posterior pancreaticoduodenal nodes (26 patients) followed by the anterior pancreaticoduodenal nodes (11 patients). No positive hepatoduodenal and common hepatic artery nodeswere found. In univariate analysis, number of positive nodes, and their ratio and locationwere significantly associated with survival. Only the factor of three or more metastatic nodes had the independent power in predicting a poor outcome in multivariate analysis (P < 0.001). Ampullary adenocarcinoma first spreads to the posterior pancreaticoduodenal nodes and then the anterior nodes. The number of positive lymph nodes, rather than their ratio and location, independently affects survival after curative resection in patients with ampullary carcinoma.",
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Pattern analysis of lymph node metastasis and the prognostic importance of number of metastatic nodes in ampullary adenocarcinoma. / Lee, Jae Hoon; Lee, Kyeong Geun; Ha, Tae Kyung; Jun, Young Jin; Paik, Seung Sam; Park, Hwon Kyum; Lee, Kwang Soo.

In: American Surgeon, Vol. 77, No. 3, 01.03.2011, p. 322-329.

Research output: Contribution to journalArticle

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AU - Lee, Kwang Soo

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