Extranodal extension influences prognosis in pancreatic body/tail cancer: A retrospective cohort study

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-06-14 DOI:10.1002/jhbp.12008

Min Kyu Sung, Jihyun Chun, Yejong Park, Bong Jun Kwak, Woohyung Lee, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim, Seung Mo Hong, Dae Wook Hwang

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Abstract

Background/Purpose

Extranodal extension (ENE) is an established prognostic factor in various malignancies, affecting survival in pancreatic head cancer (PHC). However, its significance in pancreatic body/tail cancer (PBTC) remains unclear. Therefore, we aimed to investigate the impact of ENE on PTBC prognosis.

Methods

We analyzed data collected from electronic medical records of patients with PBTC who underwent distal pancreatectomy at a single center between January 2011 and December 2015. The patients were categorized based on ENE presence and prognostic implications were evaluated using Kaplan–Meier survival curves and Cox proportional hazards model.

Results

PBTC cases involving lymph node (LN) metastasis and ENE exhibited significantly lower disease-free (DFS) and overall survival (OS) rates compared to cases without LN metastasis or ENE (median DFS; N0, 23 months; LN+/ENE−, 10 months; LN+/ENE+, 5 months; p < .001). No statistically significant difference was observed in DFS and OS rates between patients with N1/N2 in the group without ENE and those with ENE+. Multivariate analysis confirmed ENE as a significant adverse prognostic factor.

Conclusions

ENE significantly predicts poor prognosis in PBTC, particularly in cases with nodal metastasis. The current cancer staging system for PBTC should incorporate ENE status. Moreover, different staging systems should be considered for PHC and PBTC.

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结节外扩展对胰体/尾癌预后的影响：回顾性队列研究

背景/目的：结节外扩展（ENE）是各种恶性肿瘤中公认的预后因素，会影响胰头癌（PHC）的生存率。然而，其在胰体/尾癌（PBTC）中的意义仍不明确。因此，我们旨在研究 ENE 对 PTBC 预后的影响：我们分析了 2011 年 1 月至 2015 年 12 月期间在一个中心接受胰腺远端切除术的 PBTC 患者的电子病历数据。根据ENE的存在对患者进行分类，并使用Kaplan-Meier生存曲线和Cox比例危险模型评估预后影响：与无淋巴结转移或ENE的病例相比，有淋巴结（LN）转移和ENE的PBTC病例的无病生存率（DFS）和总生存率（OS）明显较低（中位DFS；N0，23个月；LN+/ENE-，10个月；LN+/ENE+，5个月；P 结论：ENE可显著预测预后不良的病例：ENE可明显预测PBTC的不良预后，尤其是在有结节转移的病例中。目前的 PBTC 癌症分期系统应纳入 ENE 状态。此外，应考虑对 PHC 和 PBTC 采用不同的分期系统。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.