Extranodal extension influences prognosis in pancreatic head cancer: A retrospective cohort study. (6th July 2022)

• Record Type: Journal Article
• Authors: Sung, Min Kyu; Park, Hosub; Park, Guisuk; Park, Seo Young; Lee, Woohyung; Song, Ki Byung; Lee, Jae Hoon; Kim, Song Cheol; Hwang, Dae Wook; Hong, Seung Mo
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 30:Number 2(2023)
• Page Start: 240
• Page End: 251
• Publication Date: 2022-07-06
• Subjects: extranodal extension -- pancreatic cancer -- prognosis -- survival -- TNM staging system; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.1199
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: Extranodal extension (ENE) is an established prognostic factor in several gastrointestinal cancers. However, the prognostic impact remains unclear. Here, we investigated the prognostic implications of ENE in patients with surgically resected pancreatic cancer. Methods: We retrospectively reviewed 476 surgically resected pancreatic head cancer patients who consecutively underwent upfront pancreaticoduodenectomy for pathologically confirmed pancreatic ductal adenocarcinoma between January 2009 and December 2013. We compared the disease‐free survival (DFS) rates of the patients according to ENE status. Results: Among the 476 patients, patients with ENE had lower DFS rates than those without ENE (N0, 13 months; LN+/ENE−, 7 months; LN+/ENE+, 6 months; P < .001). In addition, even in the same N stage, patients with ENE had lower DFS rates than those without ENE (N0, 13 months; N1/ENE− 8 months; N1/ENE+, 7 months; N2/ENE−, 7 months; N2/ENE+, 4 months, P < .001). However, there was no significant difference in survival rates between patients in the N1/ENE+ group and those in the N2/ENE− group. Additionally, ENE was an independent prognostic factor for pancreatic cancer. Conclusions: Extranodal extension significantly predicted a poor prognosis among patients with pancreatic head cancer, especially those with nodal metastasis. Therefore, ENE should be considered a prognostic factor in future editions of the staging system. Abstract : In this study, Sung and colleagues showed that extranodal extension was a significant prognostic factor in patients with pancreatic head cancer. In subgroup analysis according to each AJCC stage, patients with extranodal extension had worse survival than those without. Extranodal extension should be considered when developing a new staging system.