Dataset Information

Prognostic importance of numbers of retrieved lymph nodes and positive lymph nodes for ampulla of vater cancer (AVC) in 2347 patients from the Surveillance, Epidemiology, and End Results (SEER) database.

ABSTRACT:

Introduction

The numbers of retrieved lymph nodes (RLNs) and positive lymph nodes (PLNs) had a significant impact on the survival of patients with ampulla of vater cancer (AVC), but the optimal numbers of the both were controversial.

Objective

The cohort study aimed to explore the prognostic value and the optimal point of RLNs and PLNs for AVC.

Methods

A total of 2347 AVC patients with M0 disease who underwent surgical resection and lymph node dissection from January 2004 to December 2013 were acquired from a prospective database.

Results

The study found that the optimal cut-off values of RLNs were 18 in the N0 cohort and 16 in N1 or entire cohort due to the highest 5-year overall survival (OS) rate and disease-specific survival (DSS) rate and the separation of survival curves (all P < 0.05). In patients with RLNs ? 16, patients with PLN = 0 demonstrated significantly better 5-year OS and DSS rates (70.9% and 77.1%) compared to those with PLNs = 1-2 (41.6% and 44.7%; all P < 0.001), and patients with PLNs = 1-2 demonstrated significantly better 5-year OS and DSS rates (41.6% and 44.7%) compared to those with PLNs ? 3 (24.3% and 28.0%; all P < 0.001).

Conclusions

This article recommended that at least 16 lymph nodes will improve the prognosis of AVC patients undergoing surgery. The best cut-off values of PLNs recommended for this study were 0 and 2, which may accurately stratify patients.

SUBMITTER: Feng J

PROVIDER: S-EPMC7810317 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Prognostic importance of numbers of retrieved lymph nodes and positive lymph nodes for ampulla of vater cancer (AVC) in 2347 patients from the Surveillance, Epidemiology, and End Results (SEER) database.

Feng Jiao J Wu RuiYang R Zhang Gang G Yang ZhiMing Z Zhang Liang L

PloS one 20210115 1

<h4>Introduction</h4>The numbers of retrieved lymph nodes (RLNs) and positive lymph nodes (PLNs) had a significant impact on the survival of patients with ampulla of vater cancer (AVC), but the optimal numbers of the both were controversial.<h4>Objective</h4>The cohort study aimed to explore the prognostic value and the optimal point of RLNs and PLNs for AVC.<h4>Methods</h4>A total of 2347 AVC patients with M0 disease who underwent surgical resection and lymph node dissection from January 2004 t ...[more]

PMID: 33449948

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Project description:Tumors of the pancreas, the ampulla of Vater, and the extrahepatic and intrahepatic bile ducts have significant histological similarities due to the common embryonic origin of the pancreatobiliary system. This obviates the need for discovery of biomarkers with diagnostic and prognostic value for these tumors. Mucins, especially MUC-1, -2, -4 and -5AC, are important candidates for developing into such reliable biomarkers. Increased expression of MUC1 occurs in pancreatic ductal adenocarcinomas and is associated with increased degrees of dysplasia in pancreatic intraepithelial neoplasia (PanIN). Positive expression of MUC2 in intraductal papillary mucinus neoplasms (IPMN) of the intestinal type indicates high potential progression to invasive carcinoma with de novo expression of MUC1, while absence of MUC2 expression in IPMNs of gastric type implies low potential to malignant evolution. De novo MUC4 expression correlates to the severity of dysplasia in PanIN and is associated with a poor prognosis in patients with pancreatic ductal adenocarcinomas. In biliary intraepithelial neoplasia (BilIN), increased expression of MUC1 is associated with higher degrees of dysplasia. Intrahepatic cholangiocarcinomas (ICC) are characterized by increased expression of all glycoforms of MUC1. Positive MUC2 expression in intraductal papillary neoplasm of the bile ducts (IPNB) of the intestinal type indicates high malignant potential with de novo expression of MUC1 in the invasive element. Absent MUC2 expression in any degree of BilIN may prove useful in differentiating them from IPNB. De novo expression of MUC4 is associated with poor prognosis in patients with ICC or carcinoma of the extrahepatic bile ducts (EHBDC). High de novo expression of MUC5AC is found in all degrees of BilIN and all types of IPNB and ICC. The MUC5AC is useful in the detection of neoplastic lesions of the bile duct at an early stage. Increased expression of mucin MUC1 in carcinoma of the ampulla of Vater associated with unfavorable behavior of the tumor, such as lymph node metastasis, infiltration of the pancreas and duodenum, advanced TNM classification and worse prognosis. Patients with intra-ampullary papillary-tubular neoplasm (IAPN) of the pancreatobiliary immunophenotype did not show MUC2, while those of the intestinal immunophenotype are MUC2 positive. The expression of MUC4 is associated with poor prognosis in patients with carcinoma of the ampulla of Vater favoring metastasis and making them resistant to apoptosis. Moreover, it appears that MUC4 positivity correlates with recurrence of the tumor. Expression of MUC5AC is associated with the invasive potential of the tumor.

Project description:BackgroundLymph node (LN) involvement is an important prognostic indicator for patients with Wilms tumor (WT), and there have been previous reports of utilizing LN density (LND = positive LN/LNs examined) as an advanced metric to risk-stratify patients with WT.ObjectiveThe purpose of this study was to describe patient characteristics that affect LN yield and assess the effect of LND on the overall survival (OS) in patients with WT, with the expectation that patients with LNDs above a critical cut-point would demonstrate lower OS.Study designThe Surveillance, Epidemiology, and End Result (SEER) database was queried for all patients diagnosed with unilateral WT from 2004 to 2015. Patient and disease characteristics were collected, and Poisson regression was used to identify characteristics correlated with LN yield. LND was calculated for LN-positive patients, and multivariable survival analysis was performed, including patient demographics and LND as variables.Results1489 patients with unilateral WT were identified for analysis, 231 (15.51%) of whom were LN-positive. Median patient age at diagnosis was three years (IQR 1-5). On Poisson regression, the year of diagnosis, patient age, tumor size and laterality, and stage were found to impact LN yield. For patients with positive LNs, five-year OS of patients with LNDs above 0.4 was worse than those below 0.4 (76.1% vs 89.6%, p = 0.041). On multivariable analysis, tumor size and LND remained significant predictors of OS.DiscussionAdministrative databases such as SEER provide an excellent resource for studying conditions where large patient numbers for analysis are difficult to obtain. Unfortunately, the SEER database is unable to account for every factor that could affect LN sampling patterns. Additionally, favorable vs unfavorable histology is not available in SEER, and SEER utilizes its own staging system, which makes comparison to Children's Oncology Group staging difficult. Despite these limitations, the findings of this study are similar to those previously published using administrative databases analyzing LN sampling patterns and the effect of LND on OS in WT.ConclusionsAnalysis of the SEER database confirms that there are several patient- and disease-specific factors that affect the number of LNs sampled during nephrectomy for WT, and that LND may be a predictor of OS. These findings highlight the need for standardization of LN sampling patterns for pediatric renal tumors and support the investigation of LND in future studies to further risk-stratify WT patients to tailor therapy intensity.

Dataset Information

Prognostic importance of numbers of retrieved lymph nodes and positive lymph nodes for ampulla of vater cancer (AVC) in 2347 patients from the Surveillance, Epidemiology, and End Results (SEER) database.

Introduction

Objective

Methods

Results

Conclusions

Publications

Prognostic importance of numbers of retrieved lymph nodes and positive lymph nodes for ampulla of vater cancer (AVC) in 2347 patients from the Surveillance, Epidemiology, and End Results (SEER) database.

Similar Datasets

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