ArticleAnnals of surgical oncology2024
Evaluation of AJCC Nodal Staging for Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Ductal Adenocarcinoma.
Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Informing Decision-making for Transected Margin Reresection in Intraductal Papillary Mucinous Neoplasm-derived Pancreatic Cancer: An International Multicenter Study.Annals of surgery · 2026Article
- Incidence and Outcomes of Intraductal Oncocytic Papillary Neoplasm-Derived Pancreatic Cancer Compared with Tubular and Colloid Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Cancer: An International Multicenter Retrospective Study.Annals of surgical oncology · 2025Observational
- Defining and Predicting Early Recurrence for Optimal Treatment Strategies for Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Cancer: An International Multicenter Study.Annals of surgical oncology · 2025Article
- ASO Author Reflections: Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Cancer: A Need to Evaluate for Specific Staging Systems.Annals of surgical oncology · 2024Article
- ASO Author Reflections: The Prognostic Relevance of the Proximal Resection Margin Distance is Dependent upon the Histological Subtype of Gastric Adenocarcinoma.Annals of surgical oncology · 2024Article
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11 authors.
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Abstract
backgroundThe American Joint Committee on Cancer (AJCC) eighth edition is based on pancreatic intraepithelial neoplasia-derived pancreatic ductal adenocarcinoma (PDAC), a biologically distinct entity from intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer. The role of nodal disease and the AJCC's prognostic utility for IPMN-derived pancreatic cancer are unclear. This study aimed to evaluate the prognostic role of nodal disease and the AJCC eighth-edition N-staging for IPMN-derived pancreatic cancer.
methodsUpfront-surgery patients with IPMN-derived PDAC from four centers were stratified according to the AJCC eighth-edition N stage. Disease characteristics were compared using descriptive statistics, and both overall survival (OS) and recurrence-free survival (RFS) were evaluated using log-rank tests. Multivariable Cox regression was performed to determine the prognostic value of N stage for OS, presented as hazard ratios with 95 % confidence intervals (95 % CIs). A lowest p value log-rank statistic was used to derive the optimal cutoff for node-positive disease.
resultsFor 360 patients, advanced N stage was associated with worse T stage, grade, tubular histology, and perineural and lymphovascular invasion (all p < 0.05). The median OS was 98.3 months (95 % CI 82.8-122.0 months) for N0 disease, 27.8 months (95 % CI 24.4-41.7 months) for N1 disease, and 18.1 months (95 % CI 16.2-25.9 months) for N2 disease (p < 0.001). The AJCC N stage was validated and associated with worse OS (N1 [HR 1.64; range, 1.05-2.57], N2 [HR2.42; range, 1.48-3.96]) and RFS (N1 [HR 1.81; range, 1.23-2.68], N2 [HR 3.72; range, 2.40-5.77]). The optimal cutoff for positive nodes was five nodes.
conclusionThe AJCC eighth-edition N-staging is valid and prognostic for both OS and RFS in IPMN-derived PDAC.
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