Abstract:
OBJECTIVES:Literature addressing the significance of lymph node positivity in the management of nonfunctional pancreatic neuroendocrine tumors (PNETs) is conflicting. METHODS:The National Cancer Data Base was queried for patients who underwent surgical resection of nonfunctional PNETs between 1998 and 2011. Clinical data and overall survival were analyzed using χ and Cox proportional hazards regression. Multiple imputation was used as a comparative analysis because of the high number of patients missing data on tumor grade. RESULTS:Two thousand seven hundred thirty-five patients were identified. The overall incidence of lymph node metastasis was 51%. In the subset of patients with grade 1 tumors less than 1 cm, 24% had positive lymph nodes. Overall median survival for patients with negative lymph nodes was 11 years compared with 8 years for lymph node-positive patients (P < 0.001). On multivariate survival analysis, tumor grade, distant metastases, regional lymph node involvement, positive surgical margins, male sex, and older age were predictive of decreased overall survival. CONCLUSIONS:Lymph node positivity was associated with decreased overall survival. The incidence of lymph node involvement in resected low-grade tumors less than 1 cm is higher than previously reported. Patients selected for resection of PNETs should be offered lymphadenectomy for staging.
journal_name
Pancreasjournal_title
Pancreasauthors
Jutric Z,Grendar J,Hoen HM,Cho SW,Cassera MA,Newell PH,Hammill CW,Hansen PD,Wolf RFdoi
10.1097/MPA.0000000000000861subject
Has Abstractpub_date
2017-08-01 00:00:00pages
898-903issue
7eissn
0885-3177issn
1536-4828pii
00006676-201708000-00009journal_volume
46pub_type
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