Sporadic nonfunctional pancreatic neuroendocrine tumors: Risk of lymph node metastases and aggressiveness according to tumor size: A multicenter international study

被引：8

作者：

Perinel, Julie ^{[1
]}

Nappo, Gennaro ^{[2
]}

Zerbi, Alessandro ^{[2
,3
]}

Heidsma, Charlotte M. ^{[4
]}

van Dijkum, Elisabeth J. M. Nieveen ^{[4
]}

Han, Ho Seong ^{[5
]}

Yoon, Yoo-Seok ^{[5
]}

Satoi, Sohei ^{[6
,7
]}

Demir, Ihsan Ekin ^{[8
]}

Friess, Helmut ^{[8
]}

Vashist, Yogesh ^{[9
]}

Izbicki, Jakob ^{[10
]}

Muller, Alexandra Charlotte ^{[11
]}

Gloor, Beat ^{[11
]}

Sandini, Marta ^{[12
,13
]}

Gianotti, Luca ^{[12
,13
]}

Subtil, Fabien ^{[14
]}

Adham, Mustapha ^{[1
]}

机构：

[1] UCBL1, Hosp Civils Lyon, Lyon Sud Fac Med, Dept Digest Surg,E Herriot Hosp, Lyon, France

[2] Humanitas Clin & Res Ctr IRCCS Rozzano, Pancreat Surg Unit, Milan, Italy

[3] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[4] Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Surg, Amsterdam, Netherlands

[5] Seoul Natl Univ, Coll Med, Dept Surg, Bundang Hosp, Seoul, South Korea

[6] Kansai Med Univ, Dept Surg, Osaka, Japan

[7] Univ Colorado, Div Surg Oncol, Anschutz Med Campus, Aurora, CO USA

[8] Tech Univ Munich, Dept Surg, Fac Med, Munich, Germany

[9] Medias Klinikum, Ctr Surg Oncol, Burghausen, Germany

[10] Clin Univ Med Ctr Hamburg Eppendorf, Gen Visceral & Thorac Surg Dept, Hamburg, Germany

[11] Univ Hosp Bern, Inselspital, Bern, Switzerland

[12] Univ Milano Bicocca, Sch Med & Surg, Monza, Italy

[13] San Gerardo Hosp, Dept Surg, Monza, Italy

[14] Hosp Civils Lyon, Serv Biostat, UCBLUMR CNRS 5558, LBBE, Lyon, France

来源：

SURGERY | 2022年 / 172卷 / 03期

关键词：

SURGICAL-MANAGEMENT; RESECTION; SURGERY; CM; STRATEGY; SURVIVAL; CLASSIFICATION; COMPLICATIONS; SURVEILLANCE; INVOLVEMENT;

D O I：

10.1016/j.surg.2022.04.013

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Although the correlation between tumor size and aggressiveness is clearly established in sporadic nonfunctional pancreatic neuroendocrine tumors, the management of tumors <= 2 cm remains debated. In recent guidelines, the cut-off size to operate ranged from 1 to 2 cm. The aim of this retrospective study was to report the rate of lymph nodes metastases in resected sporadic nonfunctional pancreatic neuroendocrine tumors, according to tumor size and, second, to identify risk factors of lymph node metastases and disease-free survival. Methods: Resected sporadic nonfunctional pancreatic neuroendocrine tumors from 9 international expert centers were included (1999-2017). Functional pancreatic neuroendocrine tumors, genetic syndromes, and R2 resection were excluded. Aggressiveness was defined as microvascular invasion, perineural invasion, lymph node metastases, G3 grading, distant metastases, and/or recurrence. Results: Overall, 495 resected sporadic nonfunctional pancreatic neuroendocrine tumors were included. For tumors up to 5 cm, the risk of lymph node metastases was increased by 1.73 for every 1 cm increase in size (odds ratio = 1.73; 95% confidence interval = 1.46-2.03). Tumor size >2 cm (P < .001), perineural invasion (P = .002), microvascular invasion (P < .001), and distant metastases (P =.008) were independently associated with lymph node metastases. Tumor size >2 cm (P = .003), R1 status (P = .004), lymph node metastases (P < .001), and World Health Organization grade 3 (P = .002) were independently associated with disease-free survival. Aggressiveness rate was 13.1% in tumors <= 1 cm and 29% in tumors between 1.1 and 2 cm. Conclusion: In resected sporadic nonfunctional pancreatic neuroendocrine tumors, the risk of lymph node metastases is correlated to tumor size. Considering that sporadic nonfunctional pancreatic neuroendocrine tumors between 1.1 and 2 cm had a higher risk of lymph node metastases and

引用

页码：975 / 981

页数：7

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