The Lymph Node Ratio Is an Independent Prognostic Factor in Pancreatic Cancer Patients Who Receive Curative Resection Followed by Adjuvant Chemotherapy

290 Background: The objective of this retrospective study was to clarify prognostic factors in pancreatic cancer patients undergoing curative resection followed by adjuvant chemotherapy with gemcitabine or S-1. Methods: Both overall survival (OS) and recurrence-free survival (RFS) were examined in 122 pancreatic cancer patients who underwent curative surgery and received adjuvant gemcitabine or S-1 after surgery between 2005 and 2014. Results: When the length of OS was evaluated according to the log-rank test, significant differences were observed in lymphatic invasion and the T status. Univariate and multivariate Cox’s proportional hazard analyses demonstrated that lymphatic invasion was the only significant independent prognostic factor for both OS and RFS. The 5-year OS was 30.1% in the lymphatic invasion-negative group and 12.1% in the lymphatic invasion-positive group (p < 0.001). Moreover, the 5-year RFS was 20.5% in the lymphatic invasionnegative group and 10.4% in the lymphatic invasionpositive group (p = 0.006). Conclusions: Lymphatic invasion is the most important prognostic factor for OS and RFS in patients with pancreatic cancer who undergo curative resection followed by adjuvant chemotherapy. The present results suggest that adjuvant chemotherapy is not sufficient, especially in patients with risk factors. Such patients should be evaluated as a target group for clinical trials of novel treatments.

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LODDS is Superior to Lymph Node Ratio for the Prognosis of Node-positive Rectal Cancer Patients Treated with Preoperative Radiotherapy

Tumori Journal ◽

10.5301/tj.5000560 ◽

2016 ◽

Vol 103 (1) ◽

pp. 87-92 ◽

Cited By ~ 4

Author(s):

Ben Huang ◽

Mengdong Ni ◽

Chen Chen ◽

Guoxiang Cai ◽

Sanjun Cai

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Cancer Patients ◽

Lymph Node Ratio ◽

Preoperative Radiotherapy ◽

Independent Prognostic Factor ◽

Stage Iii ◽

Seer Database ◽

Node Ratio

Purpose Yielding pathologic-lymph node ratio (yp-LNR) was considered to be a better staging system than yp-N stage in rectal cancer patients treated with preoperative radiotherapy (pre-RT). We aimed to compare the predictive ability of yielding pathologic log odds of positive lymph nodes (yp-LODDS) with that of yp-LNR for cancer-specific survival (CSS) in stage III rectal cancer patients treated with pre-RT. Methods We analyzed stage III rectal cancer patients treated with pre-RT in the Surveillance, Epidemiology and End Results (SEER) database. Patients were classified into 4 groups, yp-LNR1 to 4, based on the LNR cutoff points 0.25, 0.50, and 0.75. Subjects were categorized into 5 groups, yp-LODDS1 to yp-LODDS5, based on the LODDS cutoff points −1, 0, 1, and 2. Univariate and multivariate Cox proportional hazards models were performed to analyze the risk factors for survival outcome. Results A total of 4,612 patients were included from the SEER database. Patients in the yp-LNR4 group could be further divided into yp-LODDS4 and yp-LODDS5 groups with 5-year CSS of 47.6% and 31.5%, respectively (p<0.001). In the multivariate analysis without yp-LODDS, yp-LNR was an independent prognostic factor (hazard ratio [HR] 2.006, 95% confidence interval [CI] 1.619-2.484, p<0.001). However, after adjusting for yp-LODDS, yp-LNR was no longer associated with CSS (p = 0.393), and yp-LODDS was identified as an independent prognostic factor (HR 1.274, 95% CI 1.069-1.520, p = 0.007). Conclusions The prognostic value of yp-LNR can be confounded by yp-LODDS. In stage III rectal cancer patients treated with pre-RT, yp-LODDS has superior discrimination power over yp-LNR and can more accurately evaluate CSS.

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