Impact of regional and racial variation in extent of lymph node dissection on survival in pancreatic adenocarcinoma: a SEER database analysis

This study examined racial and regional differences in lymph node assessment and overall survival among 3,106 patients who underwent surgical resection for pancreatic adenocarcinoma using SEER 9 data (1988–2005). Most patients (68%) had fewer than 12 lymph nodes resected, indicating inadequate lymph node assessment (ALNA). While no racial differences were observed in node‑negative patients, significant variation emerged among node‑positive patients, particularly in those with high lymph node ratios (LNR > 0.4). African American patients had significantly poorer survival compared to White and Asian/Pacific Islander patients. Regional differences in the extent of lymph node dissection were also marked. Overall, inadequate lymph node assessment and racial disparities were strong predictors of survival, underscoring the need for improved staging and equitable care in pancreatic cancer treatment.