The Clinical Impact of the Lymph Node Ratio as a Prognostic Factor after Resection of Pancreatic Cancer

Background: The prognostic value of lymph node (LN) status in patients who underwent resection for pancreatic cancer (PC) was examined in the present study. Patients and Methods: Fifty-six patients who underwent macroscopic curative resection for PC were analyzed. Twelve factors, including the number of LN metastases, LN ratio, and N category according to the Japanese Pancreatic Society classification, were analyzed using univariate and multivariate analysis. Results: The optimal cut-off value was 0.2 for the LN ratio. Positive surgical margins (p=0.022) and LN ratio >= 0.2 (p=0.017) were identified as independent prognostic factors. Among the 33 patients with regional LN metastasis, patients with LN ratio >= 0.2 had significantly worse prognosis than those with LN ratio <0.2 (median survival time 14 vs. 26 months, p=0.048), however, the differences in survival between those with N1 and those with N2 by Japanese Pancreatic Society classification were not statistically significant (p=0.85). Conclusion: The LN ratio might be more useful than other parameters as a predictor for survival after resection of PC.