Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment
Abstract Background Lymph node (LN) metastasis is an important prognostic factor in the ampulla of Vater (AoV) adenocarcinoma. Various LN parameters have been proposed, but their prognostic efficacy has not been compared in the same population. We aimed to evaluate the prognostic values of LN parame...
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BMC
2024-11-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-024-03587-z |
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| author | Namyoung Park In Rae Cho Sang Hyub Lee Joo Seong Kim Jin Ho Choi Min Woo Lee Woo Hyun Paik Kwang Ro Joo Ji Kon Ryu Yong-Tae Kim |
| author_facet | Namyoung Park In Rae Cho Sang Hyub Lee Joo Seong Kim Jin Ho Choi Min Woo Lee Woo Hyun Paik Kwang Ro Joo Ji Kon Ryu Yong-Tae Kim |
| author_sort | Namyoung Park |
| collection | DOAJ |
| description | Abstract Background Lymph node (LN) metastasis is an important prognostic factor in the ampulla of Vater (AoV) adenocarcinoma. Various LN parameters have been proposed, but their prognostic efficacy has not been compared in the same population. We aimed to evaluate the prognostic values of LN parameters in AoV adenocarcinoma patients who underwent surgical resection and adjuvant treatment based on the long-term follow-up data. Methods A total of 86 patients with surgically resected AoV adenocarcinoma followed by adjuvant treatment were analyzed. We evaluated the prognostic values of various LN parameters such as pathologic N stage, number of metastatic regional LN (LNN), LN ratio (LNR), and log odds of positive LNs (LODDS). Each LN parameter was separately analyzed using Cox regression models with the same confounders. Results The median follow-up period was 69.4 months, and the median overall survival (OS) was 114 months. The median number of dissected LNs is 15, with an interquartile range of 8 to 25. In the univariable analyses, all LN parameters showed significant prognostic efficacy for OS, disease-free survival (DFS), and distant metastasis-free survival (DMFS). In the multivariable Cox regression analyses, LNN ≥ 2 was a statistically significant prognostic factor for OS (hazard ratio (HR) 2.10, 95% confidence interval (CI), 1.11–3.97; p = 0.022), DFS (HR 2.51, 95% CI 1.28–4.93; p = 0.007), and DMFS (HR 2.74, 95% CI 1.39–5.41; p = 0.004). LNR showed significant prognostic performance for DFS (HR 2.35, 95% CI 1.23–4.50; p = 0.010), and DMFS (HR 2.26, 95% CI 1.17–4.35; p = 0.015). N stage showed significant prognostic performance in DFS (HR 1.55 for pN1; p = 0.243 and HR 4.31 for pN2; p = 0.003), DMFS (HR 1.46 for pN1; p = 0.323 and 4.59 for pN2; p = 0.002). LODDS and the presence of LN metastasis, did not demonstrate significant prognostic value across survival outcomes. Conclusions LN parameters showed good long-term predictive performance in AoV adenocarcinoma patients treated with curative resection and adjuvant treatments. Among LN parameters, LNN ≥ 2 showed better prognostic value than others. Further large-scale studies are needed to validate the clinical usefulness of various LN parameters. |
| format | Article |
| id | doaj-art-28dbb22f7ada48bcb8e41eddb0328889 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | World Journal of Surgical Oncology |
| spelling | doaj-art-28dbb22f7ada48bcb8e41eddb03288892024-11-24T12:28:44ZengBMCWorld Journal of Surgical Oncology1477-78192024-11-0122111310.1186/s12957-024-03587-zPrognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatmentNamyoung Park0In Rae Cho1Sang Hyub Lee2Joo Seong Kim3Jin Ho Choi4Min Woo Lee5Woo Hyun Paik6Kwang Ro Joo7Ji Kon Ryu8Yong-Tae Kim9Department of Gastroenterology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at GangdongDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Internal Medicine, Dongguk University College of Medicine, Dongguk University Ilsan HospitalDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Gastroenterology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at GangdongDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University HospitalAbstract Background Lymph node (LN) metastasis is an important prognostic factor in the ampulla of Vater (AoV) adenocarcinoma. Various LN parameters have been proposed, but their prognostic efficacy has not been compared in the same population. We aimed to evaluate the prognostic values of LN parameters in AoV adenocarcinoma patients who underwent surgical resection and adjuvant treatment based on the long-term follow-up data. Methods A total of 86 patients with surgically resected AoV adenocarcinoma followed by adjuvant treatment were analyzed. We evaluated the prognostic values of various LN parameters such as pathologic N stage, number of metastatic regional LN (LNN), LN ratio (LNR), and log odds of positive LNs (LODDS). Each LN parameter was separately analyzed using Cox regression models with the same confounders. Results The median follow-up period was 69.4 months, and the median overall survival (OS) was 114 months. The median number of dissected LNs is 15, with an interquartile range of 8 to 25. In the univariable analyses, all LN parameters showed significant prognostic efficacy for OS, disease-free survival (DFS), and distant metastasis-free survival (DMFS). In the multivariable Cox regression analyses, LNN ≥ 2 was a statistically significant prognostic factor for OS (hazard ratio (HR) 2.10, 95% confidence interval (CI), 1.11–3.97; p = 0.022), DFS (HR 2.51, 95% CI 1.28–4.93; p = 0.007), and DMFS (HR 2.74, 95% CI 1.39–5.41; p = 0.004). LNR showed significant prognostic performance for DFS (HR 2.35, 95% CI 1.23–4.50; p = 0.010), and DMFS (HR 2.26, 95% CI 1.17–4.35; p = 0.015). N stage showed significant prognostic performance in DFS (HR 1.55 for pN1; p = 0.243 and HR 4.31 for pN2; p = 0.003), DMFS (HR 1.46 for pN1; p = 0.323 and 4.59 for pN2; p = 0.002). LODDS and the presence of LN metastasis, did not demonstrate significant prognostic value across survival outcomes. Conclusions LN parameters showed good long-term predictive performance in AoV adenocarcinoma patients treated with curative resection and adjuvant treatments. Among LN parameters, LNN ≥ 2 showed better prognostic value than others. Further large-scale studies are needed to validate the clinical usefulness of various LN parameters.https://doi.org/10.1186/s12957-024-03587-zAmpullary adenocarcinomaLymph node metastasisPrognosis |
| spellingShingle | Namyoung Park In Rae Cho Sang Hyub Lee Joo Seong Kim Jin Ho Choi Min Woo Lee Woo Hyun Paik Kwang Ro Joo Ji Kon Ryu Yong-Tae Kim Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment World Journal of Surgical Oncology Ampullary adenocarcinoma Lymph node metastasis Prognosis |
| title | Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment |
| title_full | Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment |
| title_fullStr | Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment |
| title_full_unstemmed | Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment |
| title_short | Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment |
| title_sort | prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long term follow up data after adjuvant treatment |
| topic | Ampullary adenocarcinoma Lymph node metastasis Prognosis |
| url | https://doi.org/10.1186/s12957-024-03587-z |
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