Show simple item record

dc.contributor.authorBalcı, Serdar
dc.contributor.authorBaştürk, Olca
dc.contributor.authorSaka, Burcu
dc.contributor.authorBağcı, Pelin
dc.contributor.authorPostlewait, Lauren Mc Lendon
dc.contributor.authorTajiri, Takuma
dc.contributor.authorJang, Kee-taek
dc.contributor.authorOhike, Nobuyuki
dc.contributor.authorKim, Grace Eun Hye
dc.contributor.authorKrasinskas, Alyssa
dc.contributor.authorChoi, Hyejeong
dc.contributor.authorSarmiento, Juan Martinez
dc.contributor.authorKooby, David
dc.contributor.authorEl-Rayes, Bassel
dc.contributor.authorKnight, Jessica
dc.contributor.authorGoodman, Michael
dc.contributor.authorAkkaş, Gizem
dc.contributor.authorReid, Michelle Dian
dc.contributor.authorMaithel, Shishir Kumar
dc.contributor.authorAdsay, Nazmi Volkan
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:35:47Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:35:47Z
dc.date.issued2015en_US
dc.identifier.citationBalcı, S., Baştürk, O., Saka, B., Bağcı, P., Postlewait, L. M. L., Tajiri, T. ... Adsay, N. V. (2015). Substaging nodal status in ampullary carcinomas has significant prognostic value: Proposed revised staging based on an analysis of 313 well-characterized cases. Annals of Surgical Oncology, 22(13), 4392-4401. https://dx.doi.org/10.1245/s10434-015-4499-yen_US
dc.identifier.issn1068-9265
dc.identifier.urihttps://hdl.handle.net/20.500.12511/943
dc.identifier.urihttps://dx.doi.org/10.1245/s10434-015-4499-y
dc.description.abstractBackground: Current nodal staging (N-staging) of ampullary carcinoma in the TNM staging system distinguishes between node-negative (N0) and node-positive (N1) disease but does not consider the metastatic lymph node (LN) number. Methods: Overall, 313 patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma were categorized as N0, N1 (1–2 metastatic LNs), or N2 (?3 metastatic LNs), as proposed by Kang et al. Clinicopathological features and overall survival (OS) of the three groups were compared. Results: The median number of LNs examined was 11, and LN metastasis was present in 142 cases (45 %). When LN-positive cases were re-classified according to the proposed staging system, 82 were N1 (26 %) and 60 were N2 (19 %). There was a significant correlation between proposed N-stage and lymphovascular invasion, perineural invasion, increased tumor size (each p < 0.001), and surgical margin positivity (p = 0.001). The median OS in LN-negative cases was significantly longer than that in LN-positive cases (107.5 vs. 32 months; p < 0.001). Patients with N1 and N2 disease had median survivals of 40 and 24.5 months, respectively (p < 0.0001). In addition, 1-, 3-, and 5-year survivals were 88, 76, 62 %, respectively, for N0; 90, 55, 31.5 %, respectively, for N1; and 68, 34, 30 %, respectively for N2 (p < 0.001). Even with multivariate modeling, the association between higher proposed N stage and shorter survival persisted (hazard ratio 1.6 for N1 and 1.9 for N2; p = 0.018). Conclusions: Classification of nodal status in ampullary carcinomas based on the number of metastatic LNs has a significant prognostic value. A revised N-staging classification system should be incorporated into the TNM staging of ampullary cancers.en_US
dc.language.isoengen_US
dc.publisherSociety of Surgical Oncologyen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAmpullaryen_US
dc.subjectSignificanten_US
dc.subjectPrognosticen_US
dc.titleSubstaging nodal status in ampullary carcinomas has significant prognostic value: Proposed revised staging based on an analysis of 313 well-characterized casesen_US
dc.typearticleen_US
dc.relation.journalAnnals of Surgical Oncologyen_US
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Tıbbi Patoloji Ana Bilim Dalıen_US
dc.authorid0000-0001-6830-7701en_US
dc.identifier.volume22en_US
dc.identifier.issue13en_US
dc.identifier.startpage4392en_US
dc.identifier.endpage4401en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.identifier.doi10.1245/s10434-015-4499-yen_US


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record