ABSTRACT
Lymph node metastasis is one of the important factors influencing the prognosis of gastric cancer patients. Accurate and reasonable lymph node staging is greatly significant in evaluating the course of the disease, in estimating the prognosis, and in making a reasonable treatment plan. Local and international research institutions recently found that new staging methods for lymph nodes associated with the prognosis of gastric cancer (e.g., metastastic lymph nodes ratio, log odds of positive lymph nodes, negative lymph node count, and lymph node micrometastasis) can also predict the prognosis of gastric cancer patients. In this paper, the development history, current status of lymph node staging of gastric cancer, and research progress on the new staging methods for lymph nodes as-sociated with the prognosis of gastric cancer are reviewed.
ABSTRACT
Objective To explore the prognosis impact of lymph nodes metastasis in pancreatic cancer.Methods The clinical data of 61 patients with pancreatic cancer who underwent pancreaticoduodenectomy from January 2004 to September 2011 were analyzed retrospectively.Patients were categorized into different groups by lymph nodes metastasis status,count of positive lymph nodes,location of positive lymph nodes,lymph nodes ratio (LNR) and other factors.Kaplan-Meier,log-rank and COX proportional hazard models were used to evaluate the prognostic effect.Results Median survival for the overall 61 patients was 13 months (95％ CI 9.158-16.842),with 6 months,1 year,3 years,5 years survival rates of 84.6％,47.7％,14.3％ and 9.1％ respectively.Univariate analysis showed:the median survival of patients with and without lymph nodes metastasis had statistical significant outcome (P ＜ 0.01).Patients within the first station lymph nodes metastasis had a better outcome than those lymph nodes metastasis beyond the first station (P ＜0.05).Patients with LNR ≤0.2 had better prognosis than those LNR ＞ 0.2 (P ＜ 0.01).The number of lymph nodes examined had no effect on overall survival in either nodes-positive patients or nodes-negative patients (P ＞ 0.05).The count of positive lymph nodes did not affect the prognosis in the pN1 patients (P＞ 0.05).Multivariate analysis showed:location of positive lymph nodes and LNR were independent predictors of the prognosis in the pN1 patients.Conclusions Lymph nodes metastasis status has significant effect on the prognosis of the pancreatic cancer.Location of positive lymph nodes and LNR are independent predictors of the prognosis in the pN1 patients.The number of lymph nodes examined and the number of positive lymph nodes have no effect on the prognosis of the pancreatic cancer.