Pattern of lymph node involvement and prognosis in XXXX : direct lymph node invasion has similar survival to node-negative disease.

@entity1 @entity788 @entity1803 @entity1124 @entity5 @entity3 @entity420
Lymph node status is one of the most important predictors of survival in @entity1124 . Surgically resected @entity788 is often locally invasive and may invade directly into peripancreatic lymph nodes. The significance of direct invasion into lymph nodes in the absence of true lymphatic metastases is unclear. The purpose of this study was to retrospectively compare clinical outcome in @entity1 with @entity1124 with direct invasion into peripancreatic lymph nodes with @entity1 with node-negative @entity420 and @entity1 with true lymphatic lymph node @entity3 . A total of 380 @entity1 with invasive @entity1124 classified as @entity1803 , were evaluated: @entity420 with true lymphatic @entity3 to regional lymph nodes (248 cases), @entity420 without lymph node involvement (97 cases), and @entity420 with regional lymph nodes involved only by direct invasion from the main @entity5 mass (35 cases). Isolated lymph node involvement by direct invasion occurred in 35 of 380 (9%) @entity1 . Overall survival for @entity1 with direct invasion of lymph nodes (median survival, 21 mo; 5-year overall survival, 36%) was not statistically different from @entity1 with node-negative @entity420 (median survival, 30 mo; 5-year overall survival, 31%) (P=0.609). @entity1 with node-negative @entity420 had an improved survival compared with @entity1 with lymph node involvement by true lymphatic @entity3 (median survival, 15 mo; 5-year overall survival, 8%) (P<0.001) regardless of the number of lymph nodes involved by @entity420 . There was a trend toward decreased overall survival for @entity1 with 1 or 2 lymph nodes involved by true lymphatic @entity3 compared with @entity1 with direct invasion of @entity5 into lymph nodes (P=0.056). However, this did not reach statistical significance. Our results indicate that @entity1 with isolated direct lymph node invasion have a comparable overall survival with @entity1 with node-negative @entity420 as opposed to true lymphatic lymph node @entity3 .
