Stefano Partelli1, Ammar A Javed2, Valentina Andreasi1, Jin He2, Francesca Muffatti1, Matthew J Weiss2, Fausto Sessa3, Stefano La Rosa4, Claudio Doglioni5, Giuseppe Zamboni6, Christopher L Wolfgang2, Massimo Falconi7. 1. Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy. 2. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Department of Medicine and Surgery, University of Insubria, Varese, Italy. 4. Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland. 5. Department of Pathology, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy. 6. Department of Pathology, Ospedale "Sacro Cuore-Don Calabria", Negrar, Italy. 7. Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy. Electronic address: falconi.massimo@hsr.it.
Abstract
BACKGROUND: The most appropriate nodal staging for pancreatic neuroendocrine neoplasms (PanNENs) is unclear. Aim of the study was to evaluate the effect of the number of positive lymph nodes on prognosis after pancreaticoduodenectomy for PanNENs. METHODS: A retrospective analysis of pancreaticoduodenectomies for nonfunctioning PanNENs was performed. PanNENs with nodal metastases (N+) were classified into N1 (1 to 3 positive lymph nodes) and N2 (4 or more positive lymph nodes). Univariate and multivariate analyses of disease-free survival were performed. RESULTS: 157 patients were included. 99 patients (63%) had N0 PanNENs whereas 58 patients (37%) had nodal involvement (N+). Patients with N0 PanNENs had a 3-year disease-free survival rate of 89% compared with 83% and 75% in patients with N1 and N2 PanNENs, respectively (P < 0.0001). Independent predictors of disease-free survival were the presence of necrosis, lymph node ratio and nodal status. Factors positively correlated with the number of positive lymph nodes were the Ki67 value, the T stage and the number of examined lymph nodes. Similar percentage of N0 and N+ PanNENs was demonstrated for a cut-off of 13 examined lymph nodes. CONCLUSIONS: The number of positive lymph nodes is accurate in predicting recurrence for PanNENs. Thirteen examined lymph nodes seems to be the minimum number of lymph nodes to be resected/examined in patients who undergo pancreaticoduodenectomy for PanNENs.
BACKGROUND: The most appropriate nodal staging for pancreatic neuroendocrine neoplasms (PanNENs) is unclear. Aim of the study was to evaluate the effect of the number of positive lymph nodes on prognosis after pancreaticoduodenectomy for PanNENs. METHODS: A retrospective analysis of pancreaticoduodenectomies for nonfunctioning PanNENs was performed. PanNENs with nodal metastases (N+) were classified into N1 (1 to 3 positive lymph nodes) and N2 (4 or more positive lymph nodes). Univariate and multivariate analyses of disease-free survival were performed. RESULTS: 157 patients were included. 99 patients (63%) had N0 PanNENs whereas 58 patients (37%) had nodal involvement (N+). Patients with N0 PanNENs had a 3-year disease-free survival rate of 89% compared with 83% and 75% in patients with N1 and N2 PanNENs, respectively (P < 0.0001). Independent predictors of disease-free survival were the presence of necrosis, lymph node ratio and nodal status. Factors positively correlated with the number of positive lymph nodes were the Ki67 value, the T stage and the number of examined lymph nodes. Similar percentage of N0 and N+ PanNENs was demonstrated for a cut-off of 13 examined lymph nodes. CONCLUSIONS: The number of positive lymph nodes is accurate in predicting recurrence for PanNENs. Thirteen examined lymph nodes seems to be the minimum number of lymph nodes to be resected/examined in patients who undergo pancreaticoduodenectomy for PanNENs.
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: Masayuki Tanaka; Max Heckler; André L Mihaljevic; Pascal Probst; Ulla Klaiber; Ulrike Heger; Simon Schimmack; Markus W Büchler; Thilo Hackert Journal: Ann Surg Oncol Date: 2020-07-27 Impact factor: 5.344
Authors: V Andreasi; S Partelli; M F Manzoni; F Muffatti; L Di Filippo; S Crippa; A Corti; M Falconi Journal: J Endocrinol Invest Date: 2022-02-05 Impact factor: 4.256
Authors: V Andreasi; C Ricci; R Casadei; M Falconi; S Partelli; G Guarneri; C Ingaldi; F Muffatti; S Crippa Journal: J Endocrinol Invest Date: 2021-11-13 Impact factor: 4.256
Authors: P Mapelli; C Bezzi; D Palumbo; C Canevari; S Ghezzo; A M Samanes Gajate; B Catalfamo; A Messina; L Presotto; A Guarnaccia; V Bettinardi; F Muffatti; V Andreasi; M Schiavo Lena; L Gianolli; S Partelli; M Falconi; P Scifo; F De Cobelli; M Picchio Journal: Eur J Nucl Med Mol Imaging Date: 2022-02-14 Impact factor: 10.057
Authors: G Capretti; G Nappo; V Smiroldo; M Cereda; B Branciforte; P Spaggiari; S Carrara; P Preatoni; F Gavazzi; C Ridolfi; G Donisi; A Lania; A Zerbi Journal: Gastroenterol Res Pract Date: 2019-04-21 Impact factor: 2.260
Authors: Angela Lamarca; Hamish Clouston; Jorge Barriuso; Mairéad G McNamara; Melissa Frizziero; Was Mansoor; Richard A Hubner; Prakash Manoharan; Sarah O'Dwyer; Juan W Valle Journal: J Clin Med Date: 2019-10-05 Impact factor: 4.241