Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors
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 perform...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-05-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-022-01595-y |
| _version_ | 1828346908748283904 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Zheng Zhang |
| collection | DOAJ |
| description | 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 < 0.001) and size (P = 0.049) predicted LNM in entire cohort. Grade (P = 0.002) predicted LNM while regardless of size in grade 2/3 cohort. Conclusions Based on our own retrospective data obtained from a single center series, LNM seems to be associated with poorer outcome for patients with grade 2/3 and/or grade 1 > 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. |
| first_indexed | 2024-04-14T00:32:44Z |
| format | Article |
| id | doaj.art-0448775119ee4644b073254a0ad42568 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-14T00:32:44Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-0448775119ee4644b073254a0ad425682022-12-22T02:22:30ZengBMCBMC Surgery1471-24822022-05-012211910.1186/s12893-022-01595-yValue of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumorsZheng Zhang0Fei Wang1Zheng Li2Zeng Ye3Qifeng Zhuo4Wenyan Xu5Wensheng Liu6Mengqi Liu7Guixiong Fan8Yi Qin9Yue Zhang10Xuemin Chen11Xianjun Yu12Xiaowu Xu13Shunrong Ji14Department of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterThe First People’s Hospital of ChangzhouThe First People’s Hospital of ChangzhouDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer CenterAbstract 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 < 0.001) and size (P = 0.049) predicted LNM in entire cohort. Grade (P = 0.002) predicted LNM while regardless of size in grade 2/3 cohort. Conclusions Based on our own retrospective data obtained from a single center series, LNM seems to be associated with poorer outcome for patients with grade 2/3 and/or grade 1 > 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.https://doi.org/10.1186/s12893-022-01595-yLymph node metastasisLymphadenectomyPancreatic neuroendocrine tumors |
| spellingShingle | 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 Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors BMC Surgery Lymph node metastasis Lymphadenectomy Pancreatic neuroendocrine tumors |
| title | Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors |
| title_full | Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors |
| title_fullStr | Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors |
| title_full_unstemmed | Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors |
| title_short | Value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors |
| title_sort | value of lymphadenectomy in patients with surgically resected pancreatic neuroendocrine tumors |
| topic | Lymph node metastasis Lymphadenectomy Pancreatic neuroendocrine tumors |
| url | https://doi.org/10.1186/s12893-022-01595-y |
| work_keys_str_mv | AT zhengzhang valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT feiwang valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT zhengli valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT zengye valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT qifengzhuo valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT wenyanxu valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT wenshengliu valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT mengqiliu valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT guixiongfan valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT yiqin valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT yuezhang valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT xueminchen valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT xianjunyu valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT xiaowuxu valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors AT shunrongji valueoflymphadenectomyinpatientswithsurgicallyresectedpancreaticneuroendocrinetumors |