Abstract
To investigate the correlation between lymph node metastasis (LNM) and various clinicopathological features of pancreatic neuroendocrine tumors (pNETs) and its impact on prognosis. We searched the Surveillance Epidemiology and End Results database (2004-2015) for patients with surgically treated pNETs. Factors correlated with LNMs were analyzed by logistic regression and by Cox analysis. For tumors of 1 to 4 cm, age (P < 0.001, P = 0.014), grade (P < 0.001, P < 0.001), LNMs (P = 0.008, P < 0.001), and size (P = 0.038, P = 0.002) predicted overall survival (OS) and disease-specific survival (DSS). For tumor greater than 4 cm, age (P < 0.001, P = 0.001) and grade (P = 0.011, P = 0.048) were independent prognostic factors of OS and DSS. Lymph node metastasis modestly predicted DSS (P = 0.028) but not OS (P = 0.218). In pNETs greater than 4 cm, LNM is not a predictor of OS and modestly predicts DSS, and lymphadenectomy may be unhelpful in these patients. For pNETs 1 to 4 cm, LNM predicts poor OS and DSS, which supports lymphadenectomy in these patients. Pancreas-sparing resection with only limited peripancreatic node sampling needs to be questioned.
References
Jul 27, 2001·Best Practice & Research. Clinical Endocrinology & Metabolism·L Fernández-CruzM Sierra
Jul 21, 2005·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Megan Dann FesinmeyerDeborah J Bowen
Aug 23, 2006·Archives of Surgery·Kevork K KazanjianOscar J Hines
Feb 22, 2007·Neuroendocrinology·Massimo FalconiUNKNOWN European Neuroendocrine Tumor Society
Jan 23, 2008·Annals of Oncology : Official Journal of the European Society for Medical Oncology·R BettiniM Falconi
Apr 1, 2008·Annals of Surgery·Karl Y BilimoriaDavid J Bentrem
Jun 3, 2008·Annals of Oncology : Official Journal of the European Society for Medical Oncology·T R HalfdanarsonG M Petersen
Dec 3, 2008·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Sara EkebladBarbro Eriksson
Sep 22, 2009·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Nikiforos BallianClifford S Cho
Dec 10, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jan FrankoA James Moser
Mar 13, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hiromichi ItoEdward E Whang
Mar 23, 2010·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Aldo ScarpaMassimo Falconi
May 1, 2010·Pancreas·Riccardo CasadeiFrancesco Minni
Jul 6, 2010·The Journal of Surgical Research·Jillian K SmithTheodore P McDade
Sep 9, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Joseph DiNorciaJohn D Allendorf
Jun 21, 2011·Surgery·Rossella BettiniMassimo Falconi
Dec 27, 2011·Current Treatment Options in Oncology·William R Burns, Barish H Edil
Feb 11, 2012·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Laureano Fernández-CruzJoana Ferrer
May 16, 2013·Annals of Surgery·Trevor A EllisonBarish H Edil
Aug 30, 2013·JAMA Surgery·Stefano PartelliMassimo Falconi
Nov 21, 2013·Annals of Surgery·Yassar M HashimWilliam G Hawkins
May 21, 2014·Annals of Surgical Oncology·Lauren GratianJulie Ann Sosa
Jul 7, 2014·American Journal of Surgery·Joyce WongPamela J Hodul
Jun 24, 2016·Journal of Surgical Oncology·Lauren M PostlewaitShishir K Maithel
Oct 8, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Claudius ConradJeffrey E Lee
Nov 5, 2016·Biochemia Medica·Farrokh HabibzadehMahboobeh Yadollahie
Jun 13, 2018·Journal of the National Comprehensive Cancer Network : JNCCN·Manisha H ShahGriselda Zuccarino-Catania