The role of regional lymphadenectomy in surgical treatment of nonfunctional pancreatic neuroendocrine tumors / 中华肝胆外科杂志

ABSTRACT

Objective To analyze the prognostic importance of lymph node metastasis and the significance of regional lymphadenectomy in surgical treatment of nonfunctional pancreatic neuroendocrine tumors(NF-PanNET).Methods The clinical and pathological data of patients who underwent resection of NF-PanNET in Tianjin Medical University Cancer Institute and Hospital from January 2000 to December 2013 were retrospectively studied.The data included age,sex,tumor location,tumor size,lymph node metastasis,surgical resection margins,pathological grades and followed-up visits.Results Of 75 patients in this study,16 (21.3％) had lymph node metastases.Patients with larger tumors (＞3 cm) and higher tumor gradings (G3) had higher rates of lymph nodal metastasis.The overall 3-and 5-year disease-free survival (DFS) were 92.0％ and 89.2％ respectively.The 5-year DFS for patients with and without nodal metastasis were 75.0％ and 93.0％ (P＜0.05) respectively.Significantly lower 5-year DFS rates were found in patients with lymph nodal metastases,large tumor sizes (＞3 cm),high pathological gradings (G3) and positive surgical resection margins (all P＜0.05).Multivariable analysis showed that lymph nodal metastasis and surgical resection margin were independent factors associated with DFS (all P＜0.05).Conclusions Patients with NF-PanNET with lymph node metastasis had significantly higher risks of recurrence and metastasis.Patients with large tumor sizes (＞3 cm) had a higher rate of lymph node metastasis,and radical surgery with lymph node dissection is recommended for these patients.