Lymph node evaluation and survival after curative-intent resection of duodenal adenocarcinoma: A matched cohort study.

摘要: Abstract Background Lymph node (LN) metastasis in patients with duodenal adenocarcinoma is associated poor prognosis; however, the optimal extent of LN assessment and interaction between adjuvant systemic therapy poorly understood. Methods Resected non-metastatic ( n  = 1743) were identified National Cancer Database (1998–2011). Logistic regression analysis covariates metastasis. The influence increasing cut-off points on overall survival (OS) was analysed using log-rank test Cox proportional hazards modelling. Adjuvant chemotherapy (AC) surgery alone cohorts matched (1:1) by propensity scores based likelihood nodal or hazard OS cohort compared Kaplan–Meier estimates. Results metastases present 865 (49.6%) patients. Increasing an increased involvement P  = 0.008). In node-negative patients, a decreased risk death, largest actuarial differences observed for ≥15 (hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.48–0.82,  = 0.001). score-matched AC non-significant improvements 5-year (66.1% versus 58.7%, HR 0.79, CI 0.53–1.18,  = 0.249), did not vary adequacy counts  = 0.305; LNs: 0.90, 0.35–2.30,  = 0.900). Conclusions identification has prognostic significance resected adenocarcinoma, but cannot be implicated selection AC.