{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T02:00:04Z","timestamp":1760061604283},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T00:00:00Z","timestamp":1364860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007479","name":"Fondazione Cassa di Risparmio di Padova e Rovigo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007479","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006747","name":"Fondazione Cassa di Risparmio di Verona Vicenza Belluno e Ancona","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006747","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to determine the optimal number of lymph nodes (LN) examined to stage pN0 tumors after surgery for ampulla of Vater carcinoma (AVC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed retrospectively 127 patients with AVC who underwent pancreaticoduodenectomy (1990\u20132008). Univariate and multivariate analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010nine patients (46.5 %) were pN0, whereas 68 patients (53.5 %) were pN1. The 5\u2010year disease\u2010specific survival (DSS) was worse for pN1 patients than for pN0 patients (46 vs. 77 %; <jats:italic>P<\/jats:italic> &lt; 0.0001). In the pN0 cohort, the optimal cut\u2010off number of LN analyzed was found to be 12. The 5\u2010year DSS for patients with \u226412\u00a0LN was 50 %, compared with 89 % in those with &gt;12\u00a0LN (<jats:italic>P<\/jats:italic> = 0.001). By multivariate analysis, a LN count &gt;12 was the only independent predictor associated with improved survival (HR 0.16, <jats:italic>P<\/jats:italic> = 0.003) among pN0 patients. Among pN1 patients, a LN count &gt;12 was associated with a significantly better 5\u2010year DSS (59 vs. 22 %; <jats:italic>P<\/jats:italic> = 0.027). Patients with a lymph node ratio (LNR) &gt;0.20 had a 5\u2010year DSS of 24 %, compared with 58 % in those with 0 &lt; LNR \u2264 0.20 (<jats:italic>P<\/jats:italic> = 0.038).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Removal of more than 12\u00a0LN for examination is associated with improved survival rate after surgery for AVC in both pN0 and pN1 patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-1995-8","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T17:53:04Z","timestamp":1364838784000},"page":"1397-1404","source":"Crossref","is-referenced-by-count":25,"title":["Adequacy of Lymph Node Retrieval for Ampullary Cancer and Its Association with Improved Staging and Survival"],"prefix":"10.1002","volume":"37","author":[{"given":"Stefano","family":"Partelli","sequence":"first","affiliation":[{"name":"Department of Surgery University of Verona Chirurgia Generale B, Policlinico \u201cGB Rossi\u201d, Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Crippa","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Verona Chirurgia Generale B, Policlinico \u201cGB Rossi\u201d, Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Capelli","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Verona Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Neri","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Verona Chirurgia Generale B, Policlinico \u201cGB Rossi\u201d, Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Bassi","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Verona Chirurgia Generale B, Policlinico \u201cGB Rossi\u201d, Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Zamboni","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Verona Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliano","family":"Barugola","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Verona Chirurgia Generale B, Policlinico \u201cGB Rossi\u201d, Piazzale LA Scuro 37134 Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Falconi","sequence":"additional","affiliation":[{"name":"Dipartimento Chirurgia Pancreatica Universit\u00e0 Politecnica delle Marche A.O.U. Ospedali Riuniti, Via Conca 71 60126 Torrette\u2010Ancona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,2]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2005.08.002"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199807000\u201000013"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199705000\u201000015"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102407\u20108\u2010170"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.07.512"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010007\u20100117\u20106"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.05.012"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010006\u20100213\u20103"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010009\u20101080\u20107"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20665"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.6.529"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010008\u20100099\u20104"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.14.621"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.10140"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.9.881"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.03.058"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010007\u20109587\u20101"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.142.8.767"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e31816074c9"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181d3d2b2"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31822238d8"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-88443-1"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5716"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200209000\u201000012"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010006\u20109016\u2010x"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6076"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2009.210"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908721"},{"key":"e_1_2_6_30_2","first-page":"362","article-title":"Adjuvant treatment for ampullary cancer. Highlights from the \u201c2011 ASCO Annual Meeting\u201d, Chicago, June 3\u20137, 2011","volume":"12","author":"Kim R","year":"2011","journal-title":"J Pancreas"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2011.29.18_suppl.lba4006"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-013-1995-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-013-1995-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-013-1995-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:11:25Z","timestamp":1703603485000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-013-1995-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,2]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2013,6]]}},"alternative-id":["10.1007\/s00268-013-1995-8"],"URL":"https:\/\/doi.org\/10.1007\/s00268-013-1995-8","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,2]]}}}