Pubblicazioni

Autori:

De Pastena, Matteo; Zingaretti, Caterina Costanza; Paiella, Salvatore; Lionetto, Gabriella; Guerriero, Massimo; De Santis, Nicoletta; Luchini, Claudio; Malleo, Giuseppe; Salvia, Roberto

Titolo:

Positive Lymph Nodes Independently Affect Long-Term Survival After Pancreaticoduodenectomy for Non-Ampullary Duodenal Adenocarcinoma: A Single-Center, Retrospective Analysis

Anno:

2025

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

JOURNAL OF CLINICAL MEDICINE

ISSN Rivista:

2077-0383

N° Volume:

14

Numero o Fascicolo:

8

Intervallo pagine:

N/A-N/A

Parole chiave:

Duodenal adenocarcinoma

Breve descrizione dei contenuti:

Abstract Background/Objectives: The main treatment for non-ampullary duodenal adenocarcinoma (NDA) is pancreatoduodenectomy (PD) with lymphadenectomy (LN). Several studies have proposed a minimum number of examined lymph nodes (MNELN) to ensure proper staging. This study investigated the impact of nodal parameters—including the pattern of nodal spread—on oncologic outcomes following PD for NDA. Furthermore, we sought to determine the MNELN to ensure reliable detection of nodal involvement. Methods: This was a single-center, retrospective study. Consecutive patients who underwent PD from 2000 to 2019 with a final diagnosis of NDA were retrieved from a prospectively maintained database. The probability of detecting at least one metastatic LN in a node-positive patient was assessed using a model based on the binomial probability law. Results: A total of 70 patients met the inclusion criteria. The median number of ELNs was 35 (22–43, IQR). Thirty-six patients (51%) had at least one PLN. A node-positive disease was associated with adverse pathologic features, including high tumor grade and perineural and peripancreatic fat invasion. This translated into a greater recurrence rate (p < 0.001). The MNELN yielding a 95% probability of detecting at least one metastatic node in a node-positive patient was 25. After a median follow-up of 73 months, the median recurrence-free survival (RFS) was 33 months (95% CI 13–97), and the overall survival (OS) was 41 months (95% CI 17–96). The LN ratio, tumor grade, and metastases at stations 8 and 12 were independently associated with OS (p < 0.05). Conclusions: Nodal metastases are common among patients with NDA and have a considerable impact on long-term survival. Stations 8 and 12 were associated with OS. Therefore, an adequate lymphadenectomy, possibly including stations 8 and 12, is recommended in patients with NDA.

Id prodotto:

145262

Handle IRIS:

11562/1160088

ultima modifica:

18 aprile 2025

Citazione bibliografica:

De Pastena, Matteo; Zingaretti, Caterina Costanza; Paiella, Salvatore; Lionetto, Gabriella; Guerriero, Massimo; De Santis, Nicoletta; Luchini, Claudio; Malleo, Giuseppe; Salvia, Roberto, Positive Lymph Nodes Independently Affect Long-Term Survival After Pancreaticoduodenectomy for Non-Ampullary Duodenal Adenocarcinoma: A Single-Center, Retrospective Analysis «JOURNAL OF CLINICAL MEDICINE» , vol. 14 , n. 8 , 2025 , pp. N/A-N/A

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo