BMC Surgery (May 2022)

Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors

  • Zheng Zhang,
  • Fei Wang,
  • Zheng Li,
  • Zeng Ye,
  • Qifeng Zhuo,
  • Wenyan Xu,
  • Wensheng Liu,
  • Mengqi Liu,
  • Guixiong Fan,
  • Yi Qin,
  • Yue Zhang,
  • Xuemin Chen,
  • Xianjun Yu,
  • Xiaowu Xu,
  • Shunrong Ji

DOI
https://doi.org/10.1186/s12893-022-01595-y
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 9

Abstract

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Abstract Background Although some factors that predict the prognosis in pancreatic neuroendocrine tumor (pNET) have been confirmed, the predictive value of lymph node metastasis (LNM) in the prognosis of pNETs remains conflicting and it is not clear whether regional lymphadenectomy should be performed in all grades of tumors. Methods We included pNET patients undergoing surgery in Shanghai pancreatic cancer institute (SHPCI). The risk factors for survival were investigated by the Kaplan–Meier method and Cox regression model. We evaluated the predictors of LNM using Logistic regression. Results For 206 patients in the SHPCI series, LNM was an independent prognostic factor for entire cohort suggested by multivariate Cox regression analysis. LNM (P = 0.002) predicted poorer overall survival (OS) in grade 2/3 cohort, but there is no significant association between LNM and OS in grade 1 cohort. Grade (P 4 cm tumors. On the other way, LNM was seems to be not associated with prognosis in patients with grade 1 tumors less than 4 cm. Moreover, tumor grade and tumor size seem to act as independent predictors of LNM. Thus, regional lymphadenectomy should be performed in grade 2/3 patients but was not mandatory in grade 1 tumors < 4 cm. It is reasonable to perform functional sparing surgery for grade 1 patients or propose a clinical-radiological monitoring.

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