Prognostic Value and Clinical Predictors of Lymph Node Metastases in Pancreatic Neuroendocrine Tumors. Issue 3 (March 2020)

• Record Type: Journal Article
• Authors: Zhang, Zheng; Liu, Mengqi; Ji, Shunrong; Luo, Guopei; Xu, Wenyan; Liu, Wensheng; Hu, Qiangsheng; Sun, Qiqing; Ye, Zeng; Qin, Yi; Fan, Guixiong; Yu, Xianjun; Xu, Xiaowu
• Is Part Of: Pancreas. Volume 49:Issue 3(2020)
• Publication Date: 2020-03
• Subjects: lymph node metastasis -- lymphadenectomy -- pancreatic neuroendocrine tumors -- SEER; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001493
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: To investigate the correlation between lymph node metastasis (LNM) and various clinicopathological features of pancreatic neuroendocrine tumors (pNETs) and its impact on prognosis. Methods: 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. Results: 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). Conclusions: 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.