Prognostic significance of regional lymph node metastasis according to station in ampullary carcinoma

Background The TNM (Tumor, Node, Metastasis) classification of the 8th Union for International Cancer Control and the 6th Japanese classification of biliary tract cancer were made on the premise that the prognostic effect of each regional lymph node station is similar. However, some studies have rep...

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Published in:Journal of hepato-biliary-pancreatic sciences 2020-10, Vol.27 (10), p.712-720
Main Authors: Tashiro, Keita, Kuroki, Naomi, Einama, Takahiro, Iwasaki, Toshimitsu, Miyata, Yoichi, Aosasa, Suefumi, Inoue, Yosuke, Takahashi, Yu, Ogata, Sho, Ueno, Hideki, Hase, Kazuo, Yamamoto, Junji, Kishi, Yoji
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Language:English
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ampullary carcinoma
Lymphatic system
Medical prognosis
Metastasis
prognosis
regional lymph node
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cited_by cdi_FETCH-LOGICAL-c4201-cba17713543828165c921f99d68a313d8967fc93056578792c014761852e4e083
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container_title Journal of hepato-biliary-pancreatic sciences
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creator Tashiro, Keita
Kuroki, Naomi
Einama, Takahiro
Iwasaki, Toshimitsu
Miyata, Yoichi
Aosasa, Suefumi
Inoue, Yosuke
Takahashi, Yu
Ogata, Sho
Ueno, Hideki
Hase, Kazuo
Yamamoto, Junji
Kishi, Yoji
description Background The TNM (Tumor, Node, Metastasis) classification of the 8th Union for International Cancer Control and the 6th Japanese classification of biliary tract cancer were made on the premise that the prognostic effect of each regional lymph node station is similar. However, some studies have reported different effects of lymph node metastasis location on post‐resection prognosis. This study aimed to investigate outcome following radical resection of ampullary carcinoma according to station of lymph node metastasis. Methods Patients who underwent surgical resection for ampullary carcinoma between January 2007 and December 2017 at two separate Japanese institutions were included. Regional lymph nodes were subclassified as follows: Pancreatoduodenal lymph nodes (PD) and others (OT). Results Of the 101 patients analyzed, 34 had regional lymph node metastasis. OT metastasis was found in eight patients. Significant differences were found in relapse‐free survival (RFS) and overall survival (OS) between the three study groups (no nodal metastasis, only PD metastasis and OT metastasis; P 
doi_str_mv 10.1002/jhbp.791
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However, some studies have reported different effects of lymph node metastasis location on post‐resection prognosis. This study aimed to investigate outcome following radical resection of ampullary carcinoma according to station of lymph node metastasis. Methods Patients who underwent surgical resection for ampullary carcinoma between January 2007 and December 2017 at two separate Japanese institutions were included. Regional lymph nodes were subclassified as follows: Pancreatoduodenal lymph nodes (PD) and others (OT). Results Of the 101 patients analyzed, 34 had regional lymph node metastasis. OT metastasis was found in eight patients. Significant differences were found in relapse‐free survival (RFS) and overall survival (OS) between the three study groups (no nodal metastasis, only PD metastasis and OT metastasis; P &lt; .001 for both). OT metastasis was an independent prognostic factor in the multivariate analysis for RFS (hazard ratio [HR] 17.14; 95% confidence interval [CI], 6.33‐43.93) and OS (HR 11.06; 95% CI, 3.7‐32.99). Conclusion The poor prognosis of ampullary carcinoma patients with OT metastasis suggests that regional lymph nodes should not be categorized equally into one group. Highlight Tashiro and colleagues explored outcomes following radical resection of ampullary carcinoma according to the station of lymph node metastasis, based on a subclassification of regional lymph nodes into pancreatoduodenal and other lymph nodes. Other lymph node metastasis was associated with poor outcomes and was an independent prognostic factor on multivariate analysis.</description><identifier>ISSN: 1868-6974</identifier><identifier>EISSN: 1868-6982</identifier><identifier>DOI: 10.1002/jhbp.791</identifier><language>eng</language><publisher>Tokyo: Wiley Subscription Services, Inc</publisher><subject>ampullary carcinoma ; Lymphatic system ; Medical prognosis ; Metastasis ; prognosis ; regional lymph node</subject><ispartof>Journal of hepato-biliary-pancreatic sciences, 2020-10, Vol.27 (10), p.712-720</ispartof><rights>2020 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><rights>Copyright © 2020 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4201-cba17713543828165c921f99d68a313d8967fc93056578792c014761852e4e083</citedby><cites>FETCH-LOGICAL-c4201-cba17713543828165c921f99d68a313d8967fc93056578792c014761852e4e083</cites><orcidid>0000-0003-4158-2564 ; 0000-0003-3066-023X ; 0000-0002-5201-4477</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Tashiro, Keita</creatorcontrib><creatorcontrib>Kuroki, Naomi</creatorcontrib><creatorcontrib>Einama, Takahiro</creatorcontrib><creatorcontrib>Iwasaki, Toshimitsu</creatorcontrib><creatorcontrib>Miyata, Yoichi</creatorcontrib><creatorcontrib>Aosasa, Suefumi</creatorcontrib><creatorcontrib>Inoue, Yosuke</creatorcontrib><creatorcontrib>Takahashi, Yu</creatorcontrib><creatorcontrib>Ogata, Sho</creatorcontrib><creatorcontrib>Ueno, Hideki</creatorcontrib><creatorcontrib>Hase, Kazuo</creatorcontrib><creatorcontrib>Yamamoto, Junji</creatorcontrib><creatorcontrib>Kishi, Yoji</creatorcontrib><title>Prognostic significance of regional lymph node metastasis according to station in ampullary carcinoma</title><title>Journal of hepato-biliary-pancreatic sciences</title><description>Background The TNM (Tumor, Node, Metastasis) classification of the 8th Union for International Cancer Control and the 6th Japanese classification of biliary tract cancer were made on the premise that the prognostic effect of each regional lymph node station is similar. However, some studies have reported different effects of lymph node metastasis location on post‐resection prognosis. This study aimed to investigate outcome following radical resection of ampullary carcinoma according to station of lymph node metastasis. Methods Patients who underwent surgical resection for ampullary carcinoma between January 2007 and December 2017 at two separate Japanese institutions were included. Regional lymph nodes were subclassified as follows: Pancreatoduodenal lymph nodes (PD) and others (OT). Results Of the 101 patients analyzed, 34 had regional lymph node metastasis. OT metastasis was found in eight patients. Significant differences were found in relapse‐free survival (RFS) and overall survival (OS) between the three study groups (no nodal metastasis, only PD metastasis and OT metastasis; P &lt; .001 for both). OT metastasis was an independent prognostic factor in the multivariate analysis for RFS (hazard ratio [HR] 17.14; 95% confidence interval [CI], 6.33‐43.93) and OS (HR 11.06; 95% CI, 3.7‐32.99). Conclusion The poor prognosis of ampullary carcinoma patients with OT metastasis suggests that regional lymph nodes should not be categorized equally into one group. Highlight Tashiro and colleagues explored outcomes following radical resection of ampullary carcinoma according to the station of lymph node metastasis, based on a subclassification of regional lymph nodes into pancreatoduodenal and other lymph nodes. Other lymph node metastasis was associated with poor outcomes and was an independent prognostic factor on multivariate analysis.</description><subject>ampullary carcinoma</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>prognosis</subject><subject>regional lymph node</subject><issn>1868-6974</issn><issn>1868-6982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kFFLwzAUhYMoOObAnxDwxZfOJE2b5FGHOmXgHvQ5ZGnaZbRJTVpk_94URUHwcuFeLh-Xcw4AlxgtMULk5rDf9Usm8AmYYV7yrBScnP7sjJ6DRYwHlCrHucjRDJht8I3zcbAaRts4W1utnDbQ1zCYxnqnWtgeu34Pna8M7MygYmobodLah8q6Bg4eptuQYGgdVF0_tq0KR6hV0Nb5Tl2As1q10Sy-5xy8Pdy_rtbZ5uXxaXW7yTQlCGd6pzBjOC9ozgnHZaEFwbUQVclVElxxUbJaJ91FWTDOBNEIU1ZiXhBDDeL5HFx__e2Dfx9NHGRnozZJjTN-jJJQXAoiCsISevUHPfgxJLcTVWBGcyTo70MdfIzB1LIPtkveJEZyilxOkcsUeUKzL_TDtub4Lyef13fbif8EndaBcw</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Tashiro, Keita</creator><creator>Kuroki, Naomi</creator><creator>Einama, Takahiro</creator><creator>Iwasaki, Toshimitsu</creator><creator>Miyata, Yoichi</creator><creator>Aosasa, Suefumi</creator><creator>Inoue, Yosuke</creator><creator>Takahashi, Yu</creator><creator>Ogata, Sho</creator><creator>Ueno, Hideki</creator><creator>Hase, Kazuo</creator><creator>Yamamoto, Junji</creator><creator>Kishi, Yoji</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4158-2564</orcidid><orcidid>https://orcid.org/0000-0003-3066-023X</orcidid><orcidid>https://orcid.org/0000-0002-5201-4477</orcidid></search><sort><creationdate>202010</creationdate><title>Prognostic significance of regional lymph node metastasis according to station in ampullary carcinoma</title><author>Tashiro, Keita ; Kuroki, Naomi ; Einama, Takahiro ; Iwasaki, Toshimitsu ; Miyata, Yoichi ; Aosasa, Suefumi ; Inoue, Yosuke ; Takahashi, Yu ; Ogata, Sho ; Ueno, Hideki ; Hase, Kazuo ; Yamamoto, Junji ; Kishi, Yoji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4201-cba17713543828165c921f99d68a313d8967fc93056578792c014761852e4e083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>ampullary carcinoma</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>prognosis</topic><topic>regional lymph node</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tashiro, Keita</creatorcontrib><creatorcontrib>Kuroki, Naomi</creatorcontrib><creatorcontrib>Einama, Takahiro</creatorcontrib><creatorcontrib>Iwasaki, Toshimitsu</creatorcontrib><creatorcontrib>Miyata, Yoichi</creatorcontrib><creatorcontrib>Aosasa, Suefumi</creatorcontrib><creatorcontrib>Inoue, Yosuke</creatorcontrib><creatorcontrib>Takahashi, Yu</creatorcontrib><creatorcontrib>Ogata, Sho</creatorcontrib><creatorcontrib>Ueno, Hideki</creatorcontrib><creatorcontrib>Hase, Kazuo</creatorcontrib><creatorcontrib>Yamamoto, Junji</creatorcontrib><creatorcontrib>Kishi, Yoji</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tashiro, Keita</au><au>Kuroki, Naomi</au><au>Einama, Takahiro</au><au>Iwasaki, Toshimitsu</au><au>Miyata, Yoichi</au><au>Aosasa, Suefumi</au><au>Inoue, Yosuke</au><au>Takahashi, Yu</au><au>Ogata, Sho</au><au>Ueno, Hideki</au><au>Hase, Kazuo</au><au>Yamamoto, Junji</au><au>Kishi, Yoji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic significance of regional lymph node metastasis according to station in ampullary carcinoma</atitle><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle><date>2020-10</date><risdate>2020</risdate><volume>27</volume><issue>10</issue><spage>712</spage><epage>720</epage><pages>712-720</pages><issn>1868-6974</issn><eissn>1868-6982</eissn><abstract>Background The TNM (Tumor, Node, Metastasis) classification of the 8th Union for International Cancer Control and the 6th Japanese classification of biliary tract cancer were made on the premise that the prognostic effect of each regional lymph node station is similar. 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OT metastasis was an independent prognostic factor in the multivariate analysis for RFS (hazard ratio [HR] 17.14; 95% confidence interval [CI], 6.33‐43.93) and OS (HR 11.06; 95% CI, 3.7‐32.99). Conclusion The poor prognosis of ampullary carcinoma patients with OT metastasis suggests that regional lymph nodes should not be categorized equally into one group. Highlight Tashiro and colleagues explored outcomes following radical resection of ampullary carcinoma according to the station of lymph node metastasis, based on a subclassification of regional lymph nodes into pancreatoduodenal and other lymph nodes. 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subjects ampullary carcinoma
Lymphatic system
Medical prognosis
Metastasis
prognosis
regional lymph node
title Prognostic significance of regional lymph node metastasis according to station in ampullary carcinoma
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