Background & objectives: Pancreatic ductal adenocarcinomas(PDAC) have poor survival rates and prognosis. Important prognosticparameters are; tumour size/stage, metastatic lymph nodes count andvascular invasion. In the current AJCC staging system, there is no recommendationto specify metastatic regional lymph node localization.Methods: Metastatic sites of 82 patients with regional lymphnode metastases out of 101 patients with PDAC who underwentpancreaticoduodenectomy were classified as peripancreatic,perigastric, hepatico-communis, hepatic pedicle and otherregions. Each region’s number of metastatic lymph nodes wasdetermined. The associations between the presence of metastasesin each lymph node region and overall survival and disease-freesurvival were determined statistically.Results: Eighty cases (79.2%) had peripancreatic, 7 cases (6.9%)had perigastric, 6 cases (5.9%) had hepatico-communis, and 7 cases(6.9%) had hepatic pedicle lymph node metastasis.In survival analysis, the estimated overall and disease-free survivaltime were significantly shorter in patients with hepatic pediclelymph node metastasis (35.5 vs 11.24 month; p= 0.001, 18.55months/3.68 months; p <0.001, respectively). Although not significant,the estimated overall survival time was shorter in patientswith hepaticocommunis lymph node metastasis (34.7 months/20.5months; p= 0.32)Hepatic pedicle lymph node metastasis was an independent predictorof mortality (p=0.005) and recurrence (p=0.003) in multivariateanalysis.Conclusion: The presence of hepatic pedicle lymph nodemetastasis is an independent poor prognostic factor for mortalityand recurrence risk, according to our findings. Although notsignificant, patients with hepaticocommunis lymph node metastasishave 14-month shorter life expectancy than those without. Withthese findings, we conclude that the metastatic lymph node sitemay have an impact on the prognosis, and may be included inpathology reports.</p
