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Prognostic Value and Clinical Predictors of Lymph Node Metastases in Pancreatic Neuroendocrine Tumors.
- Source :
-
Pancreas [Pancreas] 2020 Mar; Vol. 49 (3), pp. 381-386. - Publication Year :
- 2020
-
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.<br />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.<br />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).<br />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.
- Subjects :
- Age Factors
Databases, Factual
Female
Humans
Lymph Node Excision
Lymph Nodes surgery
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Grading
Neuroendocrine Tumors mortality
Neuroendocrine Tumors surgery
Pancreatectomy
Pancreatic Neoplasms mortality
Pancreatic Neoplasms surgery
Retrospective Studies
Risk Assessment
Risk Factors
SEER Program
Time Factors
Treatment Outcome
Tumor Burden
United States
Lymph Nodes pathology
Neuroendocrine Tumors secondary
Pancreatic Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4828
- Volume :
- 49
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pancreas
- Publication Type :
- Academic Journal
- Accession number :
- 32132507
- Full Text :
- https://doi.org/10.1097/MPA.0000000000001493