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Prognostic significance of the highest peripancreatic lymph node in biliary tract adenocarcinoma.

Publication ,  Journal Article
Kelly, KJ; Dukleska, K; Kuk, D; Kingham, TP; D'Angelica, MI; DeMatteo, RP; Allen, PJ; Jarnagin, WR; Fong, Y
Published in: Ann Surg Oncol
March 2014

BACKGROUND: Patients with biliary tract adenocarcinoma with nodal involvement have a poor prognosis. There is currently no standardized method for intraoperative lymph node assessment. The current study aimed to determine the prognostic significance of the highest peripancreatic lymph node (HPLN) in biliary tract malignancy. METHODS: This was a retrospective study of patients undergoing potential curative resection of biliary tract adenocarcinoma from January 1995 through December 2010 who prospectively had intraoperative sampling of the HPLN. The median follow-up was 72.8 months. The primary end points were recurrence-free survival (RFS) and disease-specific survival (DSS). RESULTS: The rate of HPLN positivity in 110 patients undergoing exploration for potential curative resection was 30 % and did not vary with histologic subtype (gallbladder vs. cholangiocarcinoma). Eighty-five patients underwent complete gross resection. In this subset, median RFS and DSS were 34.3 months (95 % confidence interval [CI] 23.6-not reached [NR]) and 62.4 months (95 % CI 40.8-NR) for HPLN-negative patients, and 9.6 months (95 % CI 4.76-NR) and 20.5 months (95 % CI 7.4-NR) for HPLN-positive patients (p < 0.01), respectively. Median DSS was 14.6 months (95 % CI 9.6-25.4) for patients with unresectable disease. On multivariate analysis, HPLN status was an independent predictor of RFS (hazard ratio 3.73, 95 % CI 1.86-7.45; p < 0.01) and DSS (hazard ratio 3.98, 95 % CI 1.89-8.38; p < 0.01). CONCLUSIONS: HPLN status is prognostic of RFS and DSS in biliary tract adenocarcinoma. Intraoperative nodal staging by HPLN sampling warrants further investigation in a prospective trial.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

March 2014

Volume

21

Issue

3

Start / End Page

979 / 985

Location

United States

Related Subject Headings

  • Survival Rate
  • Retrospective Studies
  • Prospective Studies
  • Prognosis
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
 

Citation

APA
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Kelly, K. J., Dukleska, K., Kuk, D., Kingham, T. P., D’Angelica, M. I., DeMatteo, R. P., … Fong, Y. (2014). Prognostic significance of the highest peripancreatic lymph node in biliary tract adenocarcinoma. Ann Surg Oncol, 21(3), 979–985. https://doi.org/10.1245/s10434-013-3352-4
Kelly, Kaitlyn J., Katerina Dukleska, Deborah Kuk, T Peter Kingham, Michael I. D’Angelica, Ronald P. DeMatteo, Peter J. Allen, William R. Jarnagin, and Yuman Fong. “Prognostic significance of the highest peripancreatic lymph node in biliary tract adenocarcinoma.Ann Surg Oncol 21, no. 3 (March 2014): 979–85. https://doi.org/10.1245/s10434-013-3352-4.
Kelly KJ, Dukleska K, Kuk D, Kingham TP, D’Angelica MI, DeMatteo RP, et al. Prognostic significance of the highest peripancreatic lymph node in biliary tract adenocarcinoma. Ann Surg Oncol. 2014 Mar;21(3):979–85.
Kelly, Kaitlyn J., et al. “Prognostic significance of the highest peripancreatic lymph node in biliary tract adenocarcinoma.Ann Surg Oncol, vol. 21, no. 3, Mar. 2014, pp. 979–85. Pubmed, doi:10.1245/s10434-013-3352-4.
Kelly KJ, Dukleska K, Kuk D, Kingham TP, D’Angelica MI, DeMatteo RP, Allen PJ, Jarnagin WR, Fong Y. Prognostic significance of the highest peripancreatic lymph node in biliary tract adenocarcinoma. Ann Surg Oncol. 2014 Mar;21(3):979–985.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

March 2014

Volume

21

Issue

3

Start / End Page

979 / 985

Location

United States

Related Subject Headings

  • Survival Rate
  • Retrospective Studies
  • Prospective Studies
  • Prognosis
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male