ArticleScientific reports2026
Higher lymph node burden predicts greater chemotherapy benefit in resected pancreatic ductal adenocarcinoma: evidence from 22,045 patients.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Whether lymph node burden modifies chemotherapy effectiveness in pancreatic ductal adenocarcinoma (PDAC) has not been systematically investigated. We analyzed 22,045 surgically treated PDAC patients from the Surveillance, Epidemiology, and End Results database (2004-2022). Restricted cubic spline analysis examined chemotherapy hazard ratios across positive lymph node counts. Cox models estimated survival associations and interaction effects between N stage and chemotherapy on multiplicative and additive scales, with Fine-Gray competing risk models for sensitivity analyses. Additional sensitivity analyses included the exclusion of neoadjuvant therapy recipients, lymph node ratio (LNR) analysis, and stratification by lymph node examination adequacy. Chemotherapy absence increased disease-specific mortality (adjusted HR 1.72; 95% CI, 1.65-1.79), while N1 and N2 disease conferred additional risk (HR 1.54 and 2.05, respectively; both p < 0.001). Chemotherapy benefit increased progressively with nodal burden: hazard ratios for chemotherapy absence versus receipt were 1.52 (95% CI, 1.42-1.63) in N0, 1.80 (95% CI, 1.70-1.92) in N1, and 1.97 (95% CI, 1.83-2.12) in N2 disease. Adjusted 3-year disease-specific survival with versus without chemotherapy was 55.1% versus 39.3% (N0), 36.5% versus 18.2% (N1), and 26.4% versus 8.7% (N2). Notably, N1 patients receiving chemotherapy achieved better outcomes than N0 patients without chemotherapy. Adjusted interaction tests revealed significant multiplicative interactions (N1: 1.19; N2: 1.28) and additive interactions (RERI: N1: 0.65; N2: 1.29). These interaction patterns were validated in sensitivity analyses. Lymph node burden significantly modifies chemotherapy effectiveness in resected PDAC, with higher nodal burden patients deriving disproportionately greater benefit. These findings support risk-stratified treatment strategies incorporating lymph node status.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.