Article Abstract

Prognostic importance of lymph node ratio after resection of ampullary carcinomas

Authors: Leonardo S. Lino-Silva, Miguel A. Gómez-Álvarez, Rosa A. Salcedo-Hernández, Alejandro E. Padilla-Rosciano, Horacio N. López-Basave


Background: The prognosis of the lymph node ratio (LNR) in Vater’s ampulla carcinomas (VACs) is recently studied. However, there are not enough data in several populations like Latin American people. Our aim is to demonstrate the prognosis significance of the LNR in this setting.
Methods: Pancreaticoduodenectomies for VACs were identified (n=128) from 1980 through 2015. Based on a ROC curve, a cut-off point of 0.1 was assigned for the LNR and the population was divided into two groups for comparison.
Results: The LNR ≥0.1 group was statistically significant associated with recurrence (38.5% vs. 19.5%), pT3–T4 tumors (69.2% vs. 29.3%), poorly differentiated tumors (46.2% vs. 17.5%), lymphovascular invasion (61.5 vs. 17.1%), perineural invasion (38.5% vs. 19.5%), and positive margins (15.4% vs. 2.4%). In the multivariate analysis, LNR (HR 2.891; CI: 1.987–3.458, P=0.02), LNM (HR 2.945; CI: 2.478–3.245, P=0.002), perineural invasion (HR 3.327; CI: 3.172–4.156, P=0.003), and recurrence (HR 3.490; CI: 2.896–4.122, P=0.001) were associated with lower survival.
Conclusions: The LNR is a good predictor of survival and worse oncological outcomes for VACs after resection.