{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:02:31Z","timestamp":1788447751636,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,5,22]],"date-time":"2022-05-22T00:00:00Z","timestamp":1653177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The nodal stage of pancreatic ductal adenocarcinoma (PDAC) is revised in the AJCC 8th edition. Studies on the prognosis of PDAC according to lymph node metastasis (LNM) are still ongoing. We attempted to find the patterns of nodal involvement and to reveal its clinical significance to overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 585 patients who received pancreatic head cancer surgery diagnosed as PDAC from January 2007 to December 2016. Patients were classified into three groups: Group 1 (G1, patients without LNM), Group 2 (G2, those with LNM only in the peripancreatic area), and Group 3 (G3 those with LNM in the other area and\/or peripancreatic LNM). Risk factors were analyzed by Cox\u2010regression test and overall survival was compared by Kaplan\u2013Meier analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LNM in peripancreatic area was the most common (88.7%). In the multivariate analysis, T stage, nuclear differentiation, adjuvant treatment, and the G2 and G3 were independent risk factors for OS (G2 over G1, HR 1.384, 95% CI 1.046\u20131.802; <jats:italic>P\u2009=<\/jats:italic>\u00a0.036 and G3 over G1, HR 2.383, 95% CI 1.378\u20134.103; <jats:italic>P\u2009=<\/jats:italic>\u00a0.001). G3 showed worse OS than G2 (<jats:italic>P\u2009=<\/jats:italic>\u00a0.006). In the N1 status, LNM to the pericholedochal (PC) and superior mesenteric artery (SMA) areas resulted in worse OS than the G2 (<jats:italic>P\u2009=<\/jats:italic>\u00a0.011 and <jats:italic>P\u2009=<\/jats:italic>\u00a0.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found that LNM beyond the peripancreatic area significantly affects OS in pancreatic head cancer patients. Depending on the station of the LNM, different risk\u2010stratification and treatment strategies will need to be considered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1159","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T14:28:56Z","timestamp":1650551336000},"page":"1004-1013","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prognosis of pancreatic head cancer with different patterns of lymph node metastasis"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8830-4903","authenticated-orcid":false,"given":"Seung Ki","family":"Min","sequence":"first","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunghun","family":"You","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Wook","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7093-2469","authenticated-orcid":false,"given":"In Woong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-4491","authenticated-orcid":false,"given":"Sang Hyun","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sokyung","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hye","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Jeong","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Seok","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South 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