Prognostic value of the metastatic lymph node ratio in patients with pancreatic cancer

The purpose of the study was to analyze the prognostic value of metastatic lymph node ratio (LNR) in pancreatic cancer (PC) patients undergoing surgical operation. We retrospectively reviewed 615 patients with PC who underwent surgical operation. The clinic-pathologic factors related to lymph node metastasis (LNM) were analyzed. There are 251 patients with LNM (40.8%), 364 cases of patients without LNM (59.2%). We found that overall survival (OS) of PC was significantly correlated to histological type, degree of differentiation, clinical staging, LNM, and LNR (all P < 0.05). Multivariate Cox regression analysis demonstrated that LNR was an independent risk factor for postoperative survival rate of patients with PC (P=0.006), and the presence of LNM was not an independent factor for predicting poor prognosis. When age and gender were included in multivariate Cox proportional hazards, LNR was still the independent prognostic factor for the OS of patients with PC (P=0.013). The value of LNR in the prediction of the prognosis of PC was better than the number and presence of LNM. It provided some helpful advice for clinicians to formulating a reasonable treatment strategy.