Significance of Lymph Node Metastasis in Resectable Well-differentiated Pancreatic Neuroendocrine Tumor.

Abstract:

OBJECTIVES:Understanding the effect of lymph node metastasis (LNM) on prognosis in pancreatic neuroendocrine neoplasm is helpful for surgery and follow-up. In this study, we investigated the significance of LNM in well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification. METHODS:We retrospectively collected data for 95 consecutive patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at 6 institutions. The clinicopathological factors were compared in patients with and without LNM, and prognostic factors were analyzed. RESULTS:Lymph node metastasis was significantly associated with malignant potential of PanNET, such as larger tumor size, higher Ki-67 index, higher tumor grade, and higher incidence of lymphatic, vessel, and neural invasion. Lymph node metastasis was also associated with disease-free but not overall survival. Multivariate analysis identified NET grade 2 (G2) and G3 as independent risk factors for recurrence after curative resection. CONCLUSIONS:World Health Organization 2017 classification was the most independent prognostic factor in patients with resectable well-differentiated PanNETs. Patients with G2 and higher-grade tumors require lymph node dissection to improve prognosis.

journal_name

Pancreas

journal_title

Pancreas

authors

Harimoto N,Hoshino K,Muranushi R,Hagiwara K,Yamanaka T,Ishii N,Tsukagoshi M,Igarashi T,Tanaka H,Watanabe A,Kubo N,Araki K,Hosouchi Y,Suzuki H,Arakawa K,Hirai K,Fukazawa T,Ikota H,Shirabe K

doi

10.1097/MPA.0000000000001355

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

943-947

issue

7

eissn

0885-3177

issn

1536-4828

journal_volume

48

pub_type

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