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Evaluation of the Prognostic Factors and Significance of Lymph Node Status in Invasive Ductal Carcinoma of the Body or Tail of the Pancreas

Fujita, Takeo MD, PhD*; Nakagohri, Toshio MD, PhD*; Gotohda, Naoto MD, PhD*; Takahashi, Shinichiro MD, PhD*; Konishi, Masaru MD, PhD*; Kojima, Motohiro MD, PhD; Kinoshita, Taira MD, PhD*

doi: 10.1097/MPA.0b013e3181bd5cfa
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Objective: We evaluated prognostic indicators for distal pancreatectomy with regional lymph node dissection in pancreatic body or tail carcinoma.

Methods: Between 1993 and 2008, 50 patients with ductal carcinoma of the body or tail of the pancreas who underwent distal pancreatectomy with regional lymph node dissection were retrospectively analyzed. Clinicopathological factors associated with patient survival were evaluated.

Results: No in-hospital deaths occurred among the study patients. The overall 5-year survival rate was 19.3%, and median survival was 22.6 months. Univariate analysis revealed that lymph node metastasis, intrapancreatic neural infiltration, peripancreatic nerve plexus infiltration, and tumor differentiation affected patient survival significantly. Multivariate analysis validated lymph node metastasis as an independent prognostic factor. Moreover, the lymph nodes attached to the pancreas were the most frequent metastatic nodes, and the number of metastasis in the lymph nodes attached to the pancreas was significantly associated with survival after surgical resection.

Conclusions: Lymph node metastasis was a significant and independent prognostic factor for the surgically resected pancreatic body or tail carcinoma. Furthermore, the lymph nodes attached to the pancreas were the most frequent metastatic nodes, and these lymph nodes were potential indicators predicting both tumor extension and survival after surgery for pancreatic body or tail carcinoma.

From the Divisions of *Digestive Surgery and †Clinical Pathology, National Cancer Center Hospital East, Kashiwa, Japan.

Received for publication April 12, 2009; accepted August 5, 2009.

Reprints: Takeo Fujita, MD, PhD, Division of Digestive Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan (e-mail: takfujit@east.ncc.go.jp).

© 2010 Lippincott Williams & Wilkins, Inc.