ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2013
N0/N1, PNL, or LNR? The effect of lymph node number on accurate survival prediction in pancreatic ductal adenocarcinoma.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers.
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Who cites it
70 citing papers in PubMed.
- Laparoscopic pancreaticoduodenectomy: single-surgeon experience.Surgical endoscopy · 2015Trial
- Neoadjuvant therapy is associated with a reduced lymph node ratio in patients with potentially resectable pancreatic cancer.Annals of surgical oncology · 2015Trial
- Evaluating the prognostic significance of lymph node yield in resected pancreatic adenocarcinoma: a population-based study.World journal of surgical oncology · 2026Article
- Prognostic significance of three lymph node staging systems in pancreatic cancer with ≤ 12 and > 12 retrieved lymph nodes.Updates in surgery · 2025Article
- Log odds of negative lymph nodes/T stage as a novel predictor of post-resection outcome in non-small cell lung cancer patients.Discover oncology · 2025Article
- Tumor Characteristics and Clinical Features of the Patient as Prognostic Factors in PDAC.Cancers · 2025Review
- Survival Outcomes in Nonmetastatic pT4 Pancreatic Ductal Adenocarcinoma: A SEER Database Analysis Comparing Neoadjuvant Therapy and Upfront Surgery with Propensity Score Matching.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- SEER-based hypothesis-generating research for minimum lymph node evaluation in early-stage pancreatic ductal adenocarcinoma patients.Frontiers in surgery · 2025Article
- A novel nomogram based on the number of positive lymph nodes can predict the overall survival of patients with pancreatic head cancer after radical surgery.World journal of surgical oncology · 2024Article
- Impact of Adherence to Operative Standards and Stage-Specific Guideline-Recommended Therapy in Nonmetastatic Pancreatic Adenocarcinoma.Annals of surgical oncology · 2023Article
- Prognostic effect of CD73 in pancreatic ductal adenocarcinoma for disease-free survival after radical surgery.Journal of cancer research and clinical oncology · 2023Article
- Higher Numbers of Examined Lymph Nodes Are Associated with Increased Survival in Resected, Treatment-Naïve, Node-Positive Esophageal, Gastric, Pancreatic, and Colon Cancers.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- A population-based study of synchronous distant metastases and prognosis in patients with PDAC at initial diagnosis.Frontiers in oncology · 2023Article
- Total Neoadjuvant Treatment for Pancreatic Ductal Adenocarcinoma Is Associated With Limited Lymph Node Yield but Improved Ratio.The Journal of surgical research · 2022Article
- CHRNB2 represses pancreatic cancer migration and invasion via inhibiting β-catenin pathway.Cancer cell international · 2022Article
- Accurate Nodal Staging in Pancreatic Cancer in the Era of Neoadjuvant Therapy.World journal of surgery · 2022Article
- Artificial intelligence in pancreatic cancer.Theranostics · 2022Review
- Developing and validating a prognostic nomogram for ovarian clear cell carcinoma patients: A retrospective comparison of lymph node staging schemes with competing risk analysis.Frontiers in oncology · 2022Article
- Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer.Frontiers in oncology · 2022Article
- Toward an Optimized Staging System for Pancreatic Ductal Adenocarcinoma: A Clinically Interpretable, Artificial Intelligence-Based Model.JCO clinical cancer informatics · 2021Article
10 more citing papers are in PubMed but not listed here.
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9 authors.
Funding
Abstract
introductionWe evaluated the prognostic accuracy of LN variables (N0/N1), numbers of positive lymph nodes (PLN), and lymph node ratio (LNR) in the context of the total number of examined lymph nodes (ELN).
methodsPatients from SEER and a single institution (MGH) were reviewed and survival analyses performed in subgroups based on numbers of ELN to calculate excess risk of death (hazard ratio, HR).
resultsIn SEER and MGH, higher numbers of ELN improved the overall survival for N0 patients. The prognostic significance (N0/N1) and PLN were too variable as the importance of a single PLN depended on the total number of LN dissected. LNR consistently correlated with survival once a certain number of lymph nodes were dissected (≥13 in SEER and ≥17 in the MGH dataset).
conclusionsBetter survival for N0 patients with increasing ELN likely represents improved staging. PLN have some predictive value but the ELN strongly influence their impact on survival, suggesting the need for a ratio-based classification. LNR strongly correlates with outcome provided that a certain number of lymph nodes is evaluated, suggesting that the prognostic accuracy of any LN variable depends on the total number of ELN.
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