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RESEARCH PRODUCT
Extranodal extension in N1-adenocarcinoma of the pancreas and papilla of Vater: A systematic review and meta-analysis of its prognostic significance
Giuseppe SergiPaola CapelliMarco SolmiAldo ScarpaClaudio LuchiniNicola VeroneseAlessia NottegarEnzo ManzatoAntonio Peasubject
Time FactorsPapillaPapillary carcinomaGastroenterologyextranodal extension pancreatic adenocarcinoma papilla papillary carcinoma prognosislymph node metastasis adenocarcinoma of the pancreas (PDAC) papilla [cancer of the papilla of Vater (CPV)] extranodal extension (ENE)0302 clinical medicineRisk FactorsOdds RatioProspective cohort studylymph node metastasisHazard ratioAmpulla of VaterGastroenterologyPrognosisextranodal extension (ENE)medicine.anatomical_structureTreatment Outcome030220 oncology & carcinogenesisLymphatic Metastasisadenocarcinoma of the pancreas (PDAC)Disease ProgressionAdenocarcinoma030211 gastroenterology & hepatologymedicine.medical_specialtyAmpulla of VaterCommon Bile Duct NeoplasmsAdenocarcinomapapilla [cancer of the papilla of Vater (CPV)]Disease-Free Survival03 medical and health sciencesExtranodal extension; Pancreatic adenocarcinoma; Papilla; Papillary carcinoma; Prognosis; Gastroenterology; HepatologyPredictive Value of TestsInternal medicineExtranodal extensionmedicineHumansHepatologybusiness.industryOdds ratiomedicine.diseaseConfidence intervalSurgeryMajor duodenal papillaPancreatic NeoplasmsRelative riskLymph NodesNeoplasm Recurrence LocalbusinessPancreatic adenocarcinomadescription
The aim of the study was to investigate the prognostic role of extranodal extension (ENE) of lymph node metastasis in adenocarcinoma of the pancreas (PDAC) and papilla [cancer of the papilla of Vater (CPV)]. A PubMed and SCOPUS search from database inception until 5 January 2015 without language restrictions was conducted. Eligible were prospective studies reporting data on prognostic parameters in individuals with PDAC and/or CPV, comparing participants with the presence of ENE (ENE +) with those with intranodal extension (ENE). Data were summarized using risk ratios for number of deaths/recurrences and hazard ratios for time-dependent risk related to ENE+, adjusted for potential confounders. ENE was found to be very common in these tumors (up to about 60% in both N1-PDAC and CPV), leading to a significant increased risk for all-cause mortality [risk ratio= 1.20; 95% confidence interval (CI): 1.06'1.35, P=0.003, I2=44%; hazard ratio=1.415, 95% CI: 1.215'1.650, P <0.0001, I2= 0%] and recurrence of disease (risk ratio =1.20, 95% CI: 1.03'1.40, P=0.02, I2=0%). On the basis of our results, in PDAC and CPV, ENE should be considered mandatorily from the gross sampling and pathology report to the oncologic staging and therapeutic approach. © 2016 Wolters Kluwer Health, Inc. All rights reserved.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-01-01 |