Is Lymph Node 8a a Poor Prognostic Factor in Pancreatic Cancer?

As the most challenging human malignancies, pancreatic cancer is characterized by its insidious symptoms, low rate of surgical resection, high risk of local invasion, metastasis and recurrence, and overall dismal prognosis. Lymphatic metastasis, above all, is recognized as an early adverse event in progression of pancreatic cancer and has been described to be an independent poor prognostic factor. It should be noted that the occurrence of lymphatic metastasis is not a casual or stochastic but an ineluctable and designed event. Increasing evidences suggest that metastasis-initiating cells (MICs) and the microenvironments may act as a double-reed style in this crime. However, the exact mechanisms on how they function synergistically for this dismal clinical course remain largely elusive. Therefore, a better understanding of its molecular and cellular mechanisms involved in pancreatic lymphatic metastasis is urgently required. In this review, we will summarize the latest advances on lymphatic metastasis in pancreatic cancer.

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Erratum: Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable as well as inoperable pancreatic cancer

British Journal of Cancer ◽

10.1038/bjc.2013.591 ◽

2013 ◽

Vol 109 (7) ◽

pp. 2026-2026 ◽

Cited By ~ 1

Author(s):

M Stotz ◽

A Gerger ◽

F Eisner ◽

J Szkandera ◽

H Loibner ◽

...

Keyword(s):

Pancreatic Cancer ◽

Prognostic Factor ◽

Poor Prognostic Factor ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

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Decreased Survival of Invasive Ductal Breast Cancer Patients With Two Macrometastatic Lymph Nodes Among Few Resected Ones: Should Current Sentinel-Lymph-Node Guidelines Be Revised?

Frontiers in Oncology ◽

10.3389/fonc.2021.669890 ◽

2021 ◽

Vol 11 ◽

Author(s):

Felipe A. C. Luz ◽

Rogério A. Araújo ◽

Marcelo J. B. Silva

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Prognostic Factor ◽

Lymph Nodes ◽

Cox Regression ◽

Ductal Carcinoma ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Poor Prognostic Factor ◽

Survival Difference

PurposeSentinel-lymph-node (SLN) biopsy (SLB) is an efficient and safe axillary surgical approach with decreased morbidity than total axillary lymph node dissection (ALND) in initial patients (T1–T2). Current guidelines strongly suggest avoiding completion of ALND in patients with one or two positive SLNs that will be submitted to whole-breast radiation therapy, but must be done when three SLNs are affected.MethodsWe performed a SEER-based study with breast invasive ductal carcinoma patients treated between 2010 and 2015. Optimal cutoffs of positive LNs predictive of survival were obtained with ROC curves and survival as a continuous variable. Bias was reduced through propensity score matching. Cox regression was employed to estimate prognosis. Nomograms were constructed to analyze the predictive value of clinicopathological factors for axillary burden.ResultsOf 43,239 initial patients that had one to three analyzed LNs, only 425 had two positive LNs and matched analysis demonstrated no survival difference versus pN2 patients [HR: 0.960 (0.635–1.452), p = 0.846]. The positive-to-analyzed LN proportion demonstrated a strong prognostic factor for a low rate (1 positive to ≤1.5 analyzed) [HR = 1.567 (1.156–2.126), p = 0.004], and analysis derived from the results demonstrated that a “negative LN margin” improves survival. Nomograms shows that tumor size is the main factor of axillary burden.ConclusionMacrometastasis of two LNs is a poor prognostic factor, similar to pN2, in SLNB (-like) patients; more extensive studies including preconized therapies must be done in order to corroborate or refute the resistance of this prognostic difference in patients with two macrometastatic lymph nodes within few resected.

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