ASCO GI: Lymph Node Ratio Predicts Survival Following Pancreatic Cancer Surgery

ORLANDO, Jan. 29 -- For predicting survival after pancreatic cancer surgery, the ratio of metastatic to examined nodes might be more accurate than the absolute number metastatic nodes sampled, researchers reported here.

Moreover, in an analysis of 3,306 patients from the Surveillance, Epidemiology and End Results (SEER) database, the number of lymph nodes examined was also predictive of survival, said Timothy Pawlik, M.D., of Johns Hopkins.

But even after adjusting for other competing risk factors an increase in lymph node ratio of more than 0.4 was associated with a 2.5 times greater risk of death than a lymph node ratio of 0.0, Dr. Pawlik reported at a gastrointestinal cancers symposium.

Survival time decreased in a linear fashion as the lymph node ratio decreased, so that a ratio of 0.0 was associated with a median survival of 17 months, a ratio of 0.2 to 0.4 was associated with a median survival of 13 months, and a ration of more than 0.4 was associated with a median survival of 10 months (P

Not surprisingly, patients with metastatic nodal disease had significantly worse survival than those with node negative disease (P