Invasive intraductal papillary mucinous carcinomas of the pancreas: Predictors of survival and the role of lymph node ratio

Stefano Partelli, Carlos Fernandez Del Castillo, Claudio Bassi, William Mantovani, Sarah P. Thayer, Stefano Crippa, Cristina R. Ferrone, Massimo Falconi, Paolo Pederzoli, Andrew L. Warshaw, Roberto Salvia

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surgery for I-IPMC is unknown. Methods: The combined databases from the Surgical Department of Massachusetts General Hospital of Boston and the University of Verona were queried. We retrospectively reviewed clinical and pathologic data of all patients with resected, pathologically confirmed, I-IPMC between 1990 and 2007. Univariate and multivariate analysis were performed. Results: I-IPMCs were diagnosed in 104 patients (55 males and 49 females), median age was 69 years. Recurrent disease was identified in 49 patients (47.1%) and the median 5-year disease specific survival (DSS) was 60.1%. The median number of resected/evaluated nodes was 15 (range, 5-60). There were 60 (57.7%) patients who had negative lymph nodes (N0), whereas 44 (42.3%) had lymph node metastases (N1). Patients with lymph node metastases had a shorter 5-year DSS (28.9%) compared with patients with negative lymph nodes (80.3%; P < 0.05) As the LNR increased, 5-year DSS decreased (LNR = 0, 86.5%; LNR >0 to 0.2, 34.4%; LNR >0.2, 11.1%; P < 0.05). On multivariate analysis, LNR, the presence of a family history of pancreatic cancer and a preoperative value of Ca 19.9 > 37 U/L were significant predictors of survival (P < 0.05). Conclusions: Lymph node ratio is a strong predictor of survival after resection for invasive intraductal papillary mucinous carcinoma.

Original languageEnglish (US)
Pages (from-to)477-482
Number of pages6
JournalAnnals of surgery
Volume251
Issue number3
DOIs
StatePublished - Mar 1 2010

Fingerprint

Mucinous Adenocarcinoma
Carcinoma, Intraductal, Noninfiltrating
Papillary Carcinoma
Pancreas
Lymph Nodes
Survival
Neoplasm Metastasis
General Hospitals
Neoplasms
Multivariate Analysis
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

Invasive intraductal papillary mucinous carcinomas of the pancreas : Predictors of survival and the role of lymph node ratio. / Partelli, Stefano; Castillo, Carlos Fernandez Del; Bassi, Claudio; Mantovani, William; Thayer, Sarah P.; Crippa, Stefano; Ferrone, Cristina R.; Falconi, Massimo; Pederzoli, Paolo; Warshaw, Andrew L.; Salvia, Roberto.

In: Annals of surgery, Vol. 251, No. 3, 01.03.2010, p. 477-482.

Research output: Contribution to journalArticle

Partelli, S, Castillo, CFD, Bassi, C, Mantovani, W, Thayer, SP, Crippa, S, Ferrone, CR, Falconi, M, Pederzoli, P, Warshaw, AL & Salvia, R 2010, 'Invasive intraductal papillary mucinous carcinomas of the pancreas: Predictors of survival and the role of lymph node ratio', Annals of surgery, vol. 251, no. 3, pp. 477-482. https://doi.org/10.1097/SLA.0b013e3181cf9155
Partelli, Stefano ; Castillo, Carlos Fernandez Del ; Bassi, Claudio ; Mantovani, William ; Thayer, Sarah P. ; Crippa, Stefano ; Ferrone, Cristina R. ; Falconi, Massimo ; Pederzoli, Paolo ; Warshaw, Andrew L. ; Salvia, Roberto. / Invasive intraductal papillary mucinous carcinomas of the pancreas : Predictors of survival and the role of lymph node ratio. In: Annals of surgery. 2010 ; Vol. 251, No. 3. pp. 477-482.
@article{f10e6a65f9b847f89f9ae15bd34aa9c5,
title = "Invasive intraductal papillary mucinous carcinomas of the pancreas: Predictors of survival and the role of lymph node ratio",
abstract = "Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surgery for I-IPMC is unknown. Methods: The combined databases from the Surgical Department of Massachusetts General Hospital of Boston and the University of Verona were queried. We retrospectively reviewed clinical and pathologic data of all patients with resected, pathologically confirmed, I-IPMC between 1990 and 2007. Univariate and multivariate analysis were performed. Results: I-IPMCs were diagnosed in 104 patients (55 males and 49 females), median age was 69 years. Recurrent disease was identified in 49 patients (47.1{\%}) and the median 5-year disease specific survival (DSS) was 60.1{\%}. The median number of resected/evaluated nodes was 15 (range, 5-60). There were 60 (57.7{\%}) patients who had negative lymph nodes (N0), whereas 44 (42.3{\%}) had lymph node metastases (N1). Patients with lymph node metastases had a shorter 5-year DSS (28.9{\%}) compared with patients with negative lymph nodes (80.3{\%}; P < 0.05) As the LNR increased, 5-year DSS decreased (LNR = 0, 86.5{\%}; LNR >0 to 0.2, 34.4{\%}; LNR >0.2, 11.1{\%}; P < 0.05). On multivariate analysis, LNR, the presence of a family history of pancreatic cancer and a preoperative value of Ca 19.9 > 37 U/L were significant predictors of survival (P < 0.05). Conclusions: Lymph node ratio is a strong predictor of survival after resection for invasive intraductal papillary mucinous carcinoma.",
author = "Stefano Partelli and Castillo, {Carlos Fernandez Del} and Claudio Bassi and William Mantovani and Thayer, {Sarah P.} and Stefano Crippa and Ferrone, {Cristina R.} and Massimo Falconi and Paolo Pederzoli and Warshaw, {Andrew L.} and Roberto Salvia",
year = "2010",
month = "3",
day = "1",
doi = "10.1097/SLA.0b013e3181cf9155",
language = "English (US)",
volume = "251",
pages = "477--482",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Invasive intraductal papillary mucinous carcinomas of the pancreas

T2 - Predictors of survival and the role of lymph node ratio

AU - Partelli, Stefano

AU - Castillo, Carlos Fernandez Del

AU - Bassi, Claudio

AU - Mantovani, William

AU - Thayer, Sarah P.

AU - Crippa, Stefano

AU - Ferrone, Cristina R.

AU - Falconi, Massimo

AU - Pederzoli, Paolo

AU - Warshaw, Andrew L.

AU - Salvia, Roberto

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surgery for I-IPMC is unknown. Methods: The combined databases from the Surgical Department of Massachusetts General Hospital of Boston and the University of Verona were queried. We retrospectively reviewed clinical and pathologic data of all patients with resected, pathologically confirmed, I-IPMC between 1990 and 2007. Univariate and multivariate analysis were performed. Results: I-IPMCs were diagnosed in 104 patients (55 males and 49 females), median age was 69 years. Recurrent disease was identified in 49 patients (47.1%) and the median 5-year disease specific survival (DSS) was 60.1%. The median number of resected/evaluated nodes was 15 (range, 5-60). There were 60 (57.7%) patients who had negative lymph nodes (N0), whereas 44 (42.3%) had lymph node metastases (N1). Patients with lymph node metastases had a shorter 5-year DSS (28.9%) compared with patients with negative lymph nodes (80.3%; P < 0.05) As the LNR increased, 5-year DSS decreased (LNR = 0, 86.5%; LNR >0 to 0.2, 34.4%; LNR >0.2, 11.1%; P < 0.05). On multivariate analysis, LNR, the presence of a family history of pancreatic cancer and a preoperative value of Ca 19.9 > 37 U/L were significant predictors of survival (P < 0.05). Conclusions: Lymph node ratio is a strong predictor of survival after resection for invasive intraductal papillary mucinous carcinoma.

AB - Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surgery for I-IPMC is unknown. Methods: The combined databases from the Surgical Department of Massachusetts General Hospital of Boston and the University of Verona were queried. We retrospectively reviewed clinical and pathologic data of all patients with resected, pathologically confirmed, I-IPMC between 1990 and 2007. Univariate and multivariate analysis were performed. Results: I-IPMCs were diagnosed in 104 patients (55 males and 49 females), median age was 69 years. Recurrent disease was identified in 49 patients (47.1%) and the median 5-year disease specific survival (DSS) was 60.1%. The median number of resected/evaluated nodes was 15 (range, 5-60). There were 60 (57.7%) patients who had negative lymph nodes (N0), whereas 44 (42.3%) had lymph node metastases (N1). Patients with lymph node metastases had a shorter 5-year DSS (28.9%) compared with patients with negative lymph nodes (80.3%; P < 0.05) As the LNR increased, 5-year DSS decreased (LNR = 0, 86.5%; LNR >0 to 0.2, 34.4%; LNR >0.2, 11.1%; P < 0.05). On multivariate analysis, LNR, the presence of a family history of pancreatic cancer and a preoperative value of Ca 19.9 > 37 U/L were significant predictors of survival (P < 0.05). Conclusions: Lymph node ratio is a strong predictor of survival after resection for invasive intraductal papillary mucinous carcinoma.

UR - http://www.scopus.com/inward/record.url?scp=77649108167&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77649108167&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e3181cf9155

DO - 10.1097/SLA.0b013e3181cf9155

M3 - Article

C2 - 20142730

AN - SCOPUS:77649108167

VL - 251

SP - 477

EP - 482

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 3

ER -