Department of General Surgery, Ospedale S. Andrea, Seconda Facoltà di Medicina e Chirurgia, Sapienza University of Rome, Italy.
J Surg Oncol. 2011 Nov 1;104(6):629-33. doi: 10.1002/jso.22013. Epub 2011 Jun 28.
Survival after resection of pancreatic adenocarcinoma is poor. Several prognostic factors such as the status of the resection margin, lymph node status, or tumor grading have been identified. Aim of the study was to evaluate the prognostic significance of the lymph node ratio (LNR) for resected pancreatic ductal adenocarcinoma.
Data were collected from 101 patients who had undergone pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Patients were divided into four groups according to the absolute LNR (0, 0-0.199, 0.2-0.399, >0.4). Kaplan-Meier and Cox proportional hazard models were used to evaluate the prognostic effect.
The actuarial 3- and 5-year survival rates were 32 and 17%, respectively. The median survival was 19 months. Patients with LNR 0/0-0.199/0.2-0.399/>0.4 survived 40.2/30.5/18.1, and 13.6 months, respectively (P = 0.001). At the multivariate analysis, lymph node status was not found to be a significant prognostic factor; on the contrary LNR >0.2 (P = 0.007), positive resection margin (P = 0.001), and grading (P = 0.05) were significantly related to survival.
LNR is a more powerful predictor of survival than the lymph node status in patients undergoing pancreaticoduodenectomy for ductal adenocarcinoma.
胰腺腺癌切除后的存活率较低。已经确定了几种预后因素，例如切除边缘状态、淋巴结状态或肿瘤分级。本研究旨在评估淋巴结比率（LNR）对胰腺导管腺癌切除的预后意义。
从 101 名接受胰十二指肠切除术治疗胰腺导管腺癌的患者中收集数据。根据绝对 LNR（0、0-0.199、0.2-0.399、>0.4）将患者分为四组。采用 Kaplan-Meier 和 Cox 比例风险模型评估预后效果。
3 年和 5 年的估计生存率分别为 32%和 17%。中位生存时间为 19 个月。LNR 为 0/0-0.199/0.2-0.399/>0.4 的患者的存活时间分别为 40.2/30.5/18.1 和 13.6 个月（P=0.001）。多变量分析显示，淋巴结状态不是显著的预后因素；相反，LNR>0.2（P=0.007）、阳性切缘（P=0.001）和分级（P=0.05）与生存显著相关。
LNR 是预测接受胰十二指肠切除术治疗胰腺导管腺癌患者生存的更有力指标，优于淋巴结状态。
