TY - JOUR
T1 - Importance of Lymph Node Involvement in Pancreatic Neuroendocrine Tumors
T2 - Impact on Survival and Implications for Surgical Resection
AU - Curran, Thomas
AU - Pockaj, Barbara A.
AU - Gray, Richard J.
AU - Halfdanarson, Thorvardur R.
AU - Wasif, Nabil
N1 - Publisher Copyright:
© 2014, The Society for Surgery of the Alimentary Tract.
PY - 2014/1
Y1 - 2014/1
N2 - Methods: All patients undergoing surgery for PNETs in the Surveillance, Epidemiology, and End Results (SEER) tumor registry from 1988 to 2010 were included. Predictors of lymph node involvement and disease-specific survival (DSS) were evaluated using logistic regression and Cox regression, respectively.Background: Conflicting data exist on predictors of nodal metastases and their impact on survival in patients with pancreatic neuroendocrine tumors (PNETs). We aim to identify factors associated with lymph node involvement and evaluate the effect of nodal metastases on survival.Conclusions: High tumor grade and increasing size predict nodal metastases in patients with PNETs. N1 status is independently associated with decreased DSS. Low-grade tumors <1 cm may be observed or enucleated.Results: Patients (1,915) underwent surgery for a PNET (62 % nonfunctional). Nodal positivity was associated with increasing tumor size (p < 0.001) and grade (p < 0.001). Unadjusted DSS at 5 years was 81 % for N0, 74 % for Nx, and 69 % for N1, respectively, (p < 0.001). After adjustment for tumor size and grade, DSS was significantly decreased in N1 patients (HR 1.57; 95 % CI 1.23–1.95). For patients who had at least one node examined and had low-grade PNETs <1 cm, no nodal metastases were found.
AB - Methods: All patients undergoing surgery for PNETs in the Surveillance, Epidemiology, and End Results (SEER) tumor registry from 1988 to 2010 were included. Predictors of lymph node involvement and disease-specific survival (DSS) were evaluated using logistic regression and Cox regression, respectively.Background: Conflicting data exist on predictors of nodal metastases and their impact on survival in patients with pancreatic neuroendocrine tumors (PNETs). We aim to identify factors associated with lymph node involvement and evaluate the effect of nodal metastases on survival.Conclusions: High tumor grade and increasing size predict nodal metastases in patients with PNETs. N1 status is independently associated with decreased DSS. Low-grade tumors <1 cm may be observed or enucleated.Results: Patients (1,915) underwent surgery for a PNET (62 % nonfunctional). Nodal positivity was associated with increasing tumor size (p < 0.001) and grade (p < 0.001). Unadjusted DSS at 5 years was 81 % for N0, 74 % for Nx, and 69 % for N1, respectively, (p < 0.001). After adjustment for tumor size and grade, DSS was significantly decreased in N1 patients (HR 1.57; 95 % CI 1.23–1.95). For patients who had at least one node examined and had low-grade PNETs <1 cm, no nodal metastases were found.
KW - Lymph node
KW - Pancreatic neuroendocrine tumor
KW - Survival surgery
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U2 - 10.1007/s11605-014-2624-z
DO - 10.1007/s11605-014-2624-z
M3 - Article
C2 - 25118642
AN - SCOPUS:84939879449
SN - 1091-255X
VL - 19
SP - 152
EP - 160
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 1
ER -