scholarly journals Lymph Node Metastatic Patterns and Survival Predictors Based on Tumor Size in Pancreatic Ductal Adenocarcinoma

2021 ◽  
Author(s):  
Ning Pu ◽  
Qiangda Chen ◽  
Wei Gan ◽  
Yuandi Shen ◽  
Shanshan Gao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Ductal Adenocarcinoma ◽  
Metastatic Patterns ◽  
Survival Predictors

Lymph Node Metastatic Patterns and Survival Predictors Based on Tumor Size in Pancreatic Ductal Adenocarcinoma

2020 ◽  
Author(s):  
Ning Pu ◽  
Qiangda Chen ◽  
Wei Gan ◽  
Benedict Kinny-Köster ◽  
Hanlin Yin ◽  
...  
Keyword(s):  
Lymph Node ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Metastatic Potential ◽  
Ductal Adenocarcinoma ◽  
Cancer Specific Survival ◽  
Node Positive Disease ◽  
Mass Size ◽  
Metastatic Patterns ◽  
The Mean

Abstract BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies. Its larger mass size is widely acknowledged to be associated with increased lymph node (LN) metastatic potential. However, the quantitative relationships between tumor size and LN metastasis or survival remain unclear. Thus, this study aims to quantitatively identify the objective relationship between tumor size and prevalence of LN metastases across primary tumor size spectrums.METHODS: 9,958 resected PDAC patients without distant metastasis were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The prevalence of LN metastases, LN ratio (LNR) and N2/N1 ratio were assessed amongst different tumor sizes, and the relationships were depicted by matched curves. RESULTS: In the enrolled cohort, age, tumor site, grade, American Joint Committee on Cancer (AJCC) 8th node staging, tumor size, chemotherapy and radiotherapy were identified as significant independent predictors for overall survival (OS) and cancer-specific survival (CSS). For tumors within 1-40 mm in size, the prevalence of node positive disease is closely modelled using a logarithmic formula [0.249×ln (size) + 0.452] × 100%, and then fluctuated between 70.0% and 80.0% when beyond 40 mm. The mean LNR increased in a stepwise manner as tumor size increased from 1-5 mm (LNR=0.024) to 41-45 mm (LNR=0.177); then, beyond 45 mm, it plateaued near 0.170. N2/N1 ratio gradually increased along with tumor size from 1-5 mm (N2/N1=0.286) to 41-45 mm (N2/N1=1.016), and when tumor size reached to 41-45 mm or more, the ratio stabilized around 1.000. CONCLUSION: Regional LN involvement demonstrated a logarithmic growth with increasing tumor sizes in resectable PDAC patients. The probability of metastasis in each regional LN for resectable PDAC patients with tumors greater than 40 mm in size was near 17.0% and their overall prevalence of LN metastasis was 70%-80%. Among which, 50% of patients had an N2 stage.

scholarly journals Liver Metastases in Newly Diagnosed Pancreatic Ductal Adenocarcinoma: A Population Based Analysis

2020 ◽  
Author(s):  
Guoyi Wu ◽  
Xiaoben Pan ◽  
Baohua Wang ◽  
Xiaolei Zhu ◽  
Jing Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Metastases ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Cox Regression ◽  
Population Based ◽  
The Body ◽  
Ductal Adenocarcinoma ◽  
Rank Test ◽  
Factors Associated

Abstract Background Estimates of the incidence and prognosis of developing liver metastases at the pancreatic ductal adenocarcinoma (PDAC) diagnosis are lacking.Methods In this study, we analyzed the association of liver metastases and the PDAC patients outcome. The risk factors associated with liver metastases in PDAC patients were analyzed using multivariable logistic regression analysis. The overall survival (OS) was estimated using Kaplan-Meier curves and log-rank test. Cox regression was performed to identify factors associated with OS.Results Patients with primary PDAC in the tail of the pancreas had a higher incidence of liver metastases (62.2%) than those with PDAC in the head (28.6%). Female gender, younger age, primary PDAC in the body or tail of the pancreas, and larger primary PDAC tumor size were positively associated with the occurrence of liver metastases. The median survival of patients with liver metastases was significantly shorter than that of patients without liver metastases. Older age, unmarried status, primary PDAC in the tail of the pancreas, and tumor size ≥4 cm were risk factors for OS in the liver metastases cohort.Conclusions Population-based estimates of the incidence and prognosis of PDAC with liver metastases may help decide whether diffusion-weighted magnetic resonance imaging should be performed in patients with primary PDAC in the tail or body of the pancreas. The location of primary PDAC should be considered during the diagnosis and treatment of primary PDAC.

Prognostic Relevance of Extracapsular Lymph Node Involvement in Pancreatic Ductal Adenocarcinoma

2009 ◽  
Vol 16 (11) ◽  
pp. 3070-3079 ◽  
Author(s):  
Gregory Sergeant ◽  
Nadine Ectors ◽  
Steffen Fieuws ◽  
Raymond Aerts ◽  
Baki Topal
Keyword(s):  
Lymph Node ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Lymph Node Involvement ◽  
Ductal Adenocarcinoma ◽  
Prognostic Relevance ◽  
Node Involvement

Su1145 TUMOR SIZE, TUMOR STAGE, AND SURVIVAL OF HIGH RISK INDIVIDUALS WITH SURVEILLANCE-DETECTED PANCREATIC DUCTAL ADENOCARCINOMA

2020 ◽  
Vol 158 (6) ◽  
pp. S-523
Author(s):  
Marcia I. Canto ◽  
Tossapol Kerdsirichairat ◽  
Amanda Blackford ◽  
Anne Marie Lennon ◽  
Olaya I. Brewer Gutierrez ◽  
...  
Keyword(s):  
High Risk ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Tumor Stage ◽  
Ductal Adenocarcinoma

Quantitative PET-MRI for early treatment response assessment in pancreatic ductal adenocarcinoma.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 520-520
Author(s):  
Martin Valera Consunji ◽  
Spencer Behr ◽  
Andrew H. Ko ◽  
Margaret A. Tempero ◽  
Pelin Cinar ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Treatment Response ◽  
Early Treatment ◽  
Tumor Size ◽  
Treatment Initiation ◽  
Post Treatment ◽  
Ductal Adenocarcinoma ◽  
Imaging Biomarkers ◽  
Early Assessment ◽  
Early Treatment Response

520 Background: There is an unmet need for improved non-invasive markers to assess early treatment response in pancreatic ductal adenocarcinoma (PDAC). Assessing early treatment response using tumor size on anatomic imaging or serum carbohydrate antigen 19-9 (CA19-9) level is unreliable. In contrast, metabolic and functional imaging is a promising new tool that may differentiate responders from non-responders early on during therapy. Therefore, the objective of this pilot study was to explore the potential of integrated positron emission tomography-magnetic resonance imaging (PET-MRI) to provide imaging biomarkers of early (4 weeks post treatment initiation) response in patients with advanced PDAC. Methods: 13 patients with biopsy-proven locally advanced or metastatic PDAC underwent integrated 18F-fluorodeoxyglucose PET-MRI through the abdomen prior to, and again at 4 weeks post, treatment initiation. Patients also had computed tomography (CT) imaging of the chest, abdomen, and pelvis and serum CA19-9 levels measured, as per standard of care. Patients were classified as responders or non-responders according to RECIST (Response Evaluation Criteria In Solid Tumors) on delayed CT, at 8-12 weeks interval post treatment initiation. Changes in metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from PET, and apparent diffusion coefficient (ADC) from diffusion-weighted MRI at 4 weeks were compared between responders and non-responders. Results: Of the 13 patients, there were 7 responders (partial response by RECIST) and 6 non-responders (progressive or stable disease by RECIST). After 4 weeks of therapy, responders had a significantly greater decrease in MTV (p = 0.003) and TLG (p = 0.006) compared to non-responders. Responders also had a significantly greater increase in mean and minimum ADC (p = 0.004 and p = 0.024, respectively) compared to non-responders. Change in tumor size at 4 weeks was not significantly different between responders and non-responders (p = 0.11). Conclusions: Integrated PET-MRI can provide early assessment of treatment response in patients with advanced PDAC.

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