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. 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. 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. 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.
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. 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. 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. 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.
Authors: B Weynand; I Borbath; V Bernard; C Sempoux; J-F Gigot; C Hubert; V Lannoy; P H Deprez; A Jouret-Mourin Journal: Cytopathology Date: 2013-11-15 Impact factor: 2.073
Authors: Alex B Haynes; Vikram Deshpande; Thun Ingkakul; Parsia A Vagefi; Jackie Szymonifka; Sarah P Thayer; Cristina R Ferrone; Jennifer A Wargo; Andrew L Warshaw; Carlos Fernández-del Castillo Journal: Arch Surg Date: 2011-05
Authors: James C Yao; Manal Hassan; Alexandria Phan; Cecile Dagohoy; Colleen Leary; Jeannette E Mares; Eddie K Abdalla; Jason B Fleming; Jean-Nicolas Vauthey; Asif Rashid; Douglas B Evans Journal: J Clin Oncol Date: 2008-06-20 Impact factor: 44.544
Authors: R Bettini; L Boninsegna; W Mantovani; P Capelli; C Bassi; P Pederzoli; G F Delle Fave; F Panzuto; A Scarpa; M Falconi Journal: Ann Oncol Date: 2008-01-21 Impact factor: 32.976
Authors: Paul A Toste; Brian E Kadera; Sergei F Tatishchev; David W Dawson; Barbara M Clerkin; Raman Muthusamy; Rabindra Watson; James S Tomlinson; Oscar J Hines; Howard A Reber; Timothy R Donahue Journal: J Gastrointest Surg Date: 2013-10-08 Impact factor: 3.452
Authors: Karl Y Bilimoria; David J Bentrem; Ryan P Merkow; James S Tomlinson; Andrew K Stewart; Clifford Y Ko; Mark S Talamonti Journal: J Am Coll Surg Date: 2007-08-03 Impact factor: 6.113
Authors: G Rindi; G Klöppel; H Alhman; M Caplin; A Couvelard; W W de Herder; B Erikssson; A Falchetti; M Falconi; P Komminoth; M Körner; J M Lopes; A-M McNicol; O Nilsson; A Perren; A Scarpa; J-Y Scoazec; B Wiedenmann Journal: Virchows Arch Date: 2006-09-12 Impact factor: 4.064
Authors: Laura Prakash; Priya Bhosale; Jordan Cloyd; Michael Kim; Nathan Parker; James Yao; Arvind Dasari; Daniel Halperin; Thomas Aloia; Jeffrey E Lee; Jean Nicolas Vauthey; Jason B Fleming; Matthew H G Katz Journal: J Gastrointest Surg Date: 2016-09-15 Impact factor: 3.452
Authors: Ding Ding; Ammar A Javed; Chunhui Yuan; Michael J Wright; Zunaira N Javed; Jonathan A Teinor; I Chae Ye; Richard A Burkhart; John L Cameron; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: J Gastrointest Surg Date: 2020-02-05 Impact factor: 3.452
Authors: Mohammad Y Zaidi; Alexandra G Lopez-Aguiar; Jeffrey M Switchenko; Joseph Lipscomb; Valentina Andreasi; Stefano Partelli; Adriana C Gamboa; Rachel M Lee; George A Poultsides; Mary Dillhoff; Flavio G Rocha; Kamran Idrees; Clifford S Cho; Sharon M Weber; Ryan C Fields; Charles A Staley; Massimo Falconi; Shishir K Maithel Journal: Ann Surg Date: 2019-09 Impact factor: 12.969
Authors: Gyulnara G Kasumova; Omidreza Tabatabaie; Mariam F Eskander; Abhishek Tadikonda; Sing Chau Ng; Jennifer F Tseng Journal: J Am Coll Surg Date: 2016-12-10 Impact factor: 6.113