{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T23:58:55Z","timestamp":1780876735537,"version":"3.54.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated the prognostic impact of lymph node yield (LNY) and lymph node ratio (LNR) on disease-free survival (DFS) and overall survival (OS) after resection for pancreatic adenocarcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a retrospective cohort of 214 patients who had undergone surgical resection between 2000 and 2022), LNY was dichotomized at the median (\u226413 vs &amp;gt;13 nodes). The LNR was categorized as 0, 0.01 to 0.20, and greater than 0.20. Survival was analyzed using Kaplan-Meier\/log rank and multivariable Cox regression; node-negative category (N0) sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The LNY was not significantly associated with differences in DFS (14 vs 15 months; P = .72) or OS (18 vs 26 months; P = .27), although N0 patients showed a trend toward longer OS with higher LNY (22 vs 36 months; P = .087). The LNR statistically significantly separated DFS (19 vs 10 vs 12 months; P = .003) and OS (28 vs 20 vs 18 months; P = .045). In Cox models, an LNY below 13 was protective for DFS (hazard ratio [HR], 0.633; P\u2009=\u2009.03) and borderline for OS (HR, 0.705; P\u2009=\u2009.07). Compared with an LNR of 0, an LNR of 0.01 to 0.20 or greater than 0.20 independently predicted recurrence (HR, 1.921; P\u2009=\u2009.006 and HR, 1.745; P\u2009=\u2009.02); for OS, only an LNR greater than 0.20 remained significant (HR, 1.752; P\u2009=\u2009.01). A higher LNR was associated with lymphovascular\/perineural invasion and progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lymph node ratio is an independent prognostic marker after resection that predicts recurrence and\u2014when above 0.20\u2014mortality, whereas LNY mainly reflects staging adequacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqag037","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T12:53:00Z","timestamp":1773838380000},"source":"Crossref","is-referenced-by-count":0,"title":["Lymph node ratio as an independent predictor of survival in pancreatic adenocarcinoma: Insights from a retrospective cohort study"],"prefix":"10.1093","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1607-8254","authenticated-orcid":false,"given":"Ana Mar\u00eda","family":"Colino-Gallardo","sequence":"first","affiliation":[{"name":"Department of Surgical Pathology, Hospital Infanta Sof\u00eda, San Sebasti\u00e1n de los Reyes , Madrid,","place":["Spain"]},{"name":"Grupo de Investigaci\u00f3n en Tumores Digestivos, Hospital Cl\u00ednico San Carlos, IdiSSC , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Fern\u00e1ndez-Ace\u00f1ero","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Tumores Digestivos, Hospital Cl\u00ednico San Carlos, IdiSSC , Madrid,","place":["Spain"]},{"name":"Department of Surgical Pathology, Hospital Cl\u00ednico San Carlos , Madrid,","place":["Spain"]},{"name":"Department of Legal Medicine, Psychiatry and Surgical Pathology, Complutense University of Madrid , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Vega-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Tumores Digestivos, Hospital Cl\u00ednico San Carlos, IdiSSC , Madrid,","place":["Spain"]},{"name":"Department of Surgical Pathology, Hospital Cl\u00ednico San Carlos , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"De La Torre-Serrano","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Tumores Digestivos, Hospital Cl\u00ednico San Carlos, IdiSSC , Madrid,","place":["Spain"]},{"name":"Department of Surgical Pathology, Hospital Cl\u00ednico San Carlos , Madrid,","place":["Spain"]},{"name":"Department of Surgical Pathology, Cl\u00ednica Universidad de Navarra , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Pilar","family":"D\u00edaz-Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology, Hospital Cl\u00ednico San Carlos , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Ortega-Medina","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Tumores Digestivos, Hospital Cl\u00ednico San Carlos, IdiSSC , Madrid,","place":["Spain"]},{"name":"Department of Surgical Pathology, Hospital Cl\u00ednico San Carlos , Madrid,","place":["Spain"]},{"name":"Department of Legal Medicine, Psychiatry and Surgical Pathology, Complutense University of Madrid , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Ignacio","family":"Diez-Valladares","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Hospital Cl\u00ednico San Carlos , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mart\u00ednez-Useros","sequence":"additional","affiliation":[{"name":"Translational Oncology Division, OncoHealth Institute, FIIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz , Madrid,","place":["Spain"]},{"name":"Physiology Area, Department of Basic Health Sciences, Health Sciences Faculty, University Rey Juan Carlos , Alcorc\u00f3n, Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"2026060719352674700_aqag037-B1","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1097\/MPA.0000000000001073","article-title":"Application of the eighth edition of the American Joint Committee on Cancer staging for pancreatic 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