Evaluation of the Site and Frequency of Lymph Node Metastasis with Non-Functioning Pancreatic Neuroendocrine Tumor

2019 ◽  
Vol 60 (5-6) ◽  
pp. 219-228
Author(s):  
Wataru Izumo ◽  
Ryota Higuchi ◽  
Toru Furukawa ◽  
Takehisa Yazawa ◽  
Shuichiro Uemura ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Neuroendocrine Tumors ◽  
Pancreatic Head ◽  
Disease Free Survival ◽  
Pancreatic Neuroendocrine Tumors ◽  
Node Dissection ◽  
Free Survival ◽  
Node Metastasis

Backgrounds: The optimal lymph node dissection range in patients with non-functioning pancreatic neuroendocrine tumors is not yet clear. In this study, we investigated the site and frequency of lymph node metastasis and the significance of lymph node dissection in patients with non-functioning pancreatic neuroendocrine tumors. Methods: This retrospective study analyzed 74 patients who underwent a curative pancreatectomy for non-functioning pancreatic neuroendocrine tumors between 2000 and 2016. The site and frequency of lymph node metastasis and clinicopathological factors were evaluated. Results: The rate of synchronous lymph node metastasis was 17.6%, with 11.1 and 29.4% for tumors with diameters of 10–19 mm and ≥20 mm, respectively. Lymph node metastasis was not observed for tumors with a diameter <10 mm. Lymph node metastasis was observed along the anterior (17a: 13.3%, 17b: 12.5%) and posterior (13a: 5.9%, 13b: 26.7%) surfaces of the pancreatic head and the superior mesenteric artery (14p: 12.5%, 14d: 7.7%) in patients with non-functioning pancreatic head neuroendocrine tumors, in the common hepatic (8a: 5.3%), splenic (10: 14.3%, 11p: 17.6%, 11d: 12.5%), and super mesenteric artery (14d: 14.3%) in patients with non-functioning pancreatic body neuroendocrine tumors, and only in the splenic artery (11p: 8.3%, 11d: 7.7%) in patients with non-functioning pancreatic tail neuroendocrine tumors. Grade 2 (HR = 6.21) and synchronous lymph node metastasis (HR = 10.4) were significant risk factors for disease-free survival. The 5-year disease-free survival was 95.7, 72.6, and 0% in patients with 0, 1, and 2 prognostic factors, respectively. Conclusions: This study clarified the site and frequency of lymph node metastasis and the optimal range of lymph node dissection in patients with non-functioning pancreatic neuroendocrine tumors.

Significance of lymph node metastasis in pancreatic neuroendocrine tumors.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 210-210
Author(s):  
Katsunobu Taki ◽  
Daisuke Hashimoto ◽  
Nobuyuki Ozaki ◽  
Shinjiro Tomiyasu ◽  
Risa Inoue ◽  
...  
Keyword(s):  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Disease Free Survival ◽  
Independent Prognostic Factor ◽  
University Hospital ◽  
Clinicopathological Parameters ◽  
Node Dissection ◽  
Node Metastasis

210 Background: Pancreatic neuroendocrine tumor (PNET) is uncommon, and its prognosis is generally better than that of pancreatic cancer. Although some PNET patients have lymph node metastasis, its effect on their prognosis is unclear, lymph node dissection for PNET is controversial. Our study aimed to clarify the significance of lymph node metastasis in PNET. Methods: We retrospectively examined 83 PNET patients who underwent pancreatic resections at Kumamoto University Hospital, Saiseikai Kumamoto Hospital and Kumamoto Regional Medical Center from April 2001 to December 2014. We excluded NET G3 from them. Their clinicopathological parameters were analyzed by the absence or presence of lymph node metastasis, and with regard to disease-free survival (DFS) and overall survival (OS). Results: Although 5-year DFS was lymph node metastasis group: 73.3%, and no lymph node metastasis group: 85.0% (P = 0.474); and 5-year OS was lymph node metastasis: 91.7% and no lymph node metastasis: 96.2% (P = 0.055), lymph node metastasis was not an independent risk factor for DFS or OS in multivariate analysis. However, tumors larger than 1.8 cm were found to be an independent prognostic factor. Conclusions: Although lymph node metastasis was not an independent prognostic factor, tumors larger than 1.8 cm were an independent prognostic factor, and warrant lymph node dissection for PNET patients with tumors of this size.

Lymph Node Dissection for Small Pancreatic Neuroendocrine Tumors Does Not Impact Survival

2018 ◽  
Vol 227 (4) ◽  
pp. S242-S243
Author(s):  
Theodoros Michelakos ◽  
Giovanni Marchegiani ◽  
Carlos Fernandez-del Castillo ◽  
Marco Miotto ◽  
Sonia Cohen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Neuroendocrine Tumors ◽  
Pancreatic Neuroendocrine Tumors ◽  
Node Dissection

scholarly journals Intrahepatic cholangiocarcinoma patients without indications of lymph node metastasis not benefit from lymph node dissection

Oncotarget ◽  
2017 ◽  
Vol 8 (69) ◽  
pp. 113817-113827 ◽  
Author(s):  
Jie Hu ◽  
Fei-Yu Chen ◽  
Kai-Qian Zhou ◽  
Cheng Zhou ◽  
Ya Cao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Node Dissection ◽  
Node Metastasis

scholarly journals Is lymph node dissection mandatory among early stage endometrial cancer patients? A retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Guangmin Zhang ◽  
Hongyou Chen ◽  
Yanying Liu ◽  
Liyan Niu ◽  
Liming Jin ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Vaginal Hysterectomy ◽  
Uterine Cavity ◽  
Pathological Examination ◽  
Node Dissection ◽  
Node Metastasis ◽  
Laparoscopic Assisted Vaginal Hysterectomy

Abstract Background Whether routine lymph node dissection for early endometrial cancer is beneficial to survival is still controversial. However, surgeons usually perform lymph node dissection on all patients with early endometrial cancer. This study aimed to prove that the risk of lymph node metastasis, as defined by our standard, is very low in such patients and may change the current surgical practice. Methods 36 consecutive patients who had staged surgery for endometrial cancer were collected. All eligible patients meet the following very low risk criteria for lymph node metastasis, including: (1) preoperative diagnosis of endometrial cancer (preoperative pathological diagnosis), (2) tumors confined to the uterine cavity and not beyond the uterine body, (3) PET-MRI lymph node metastasis test is negative. PET-MRI and pathological examination were used to assess the extent and size of the tumor, the degree of muscular invasion, and lymph node metastasis. Results The median age at diagnosis was 52 years (range 35–72 years). The median tumor size on PET-MRI was 2.82 cm (range 0.66–6.37 cm). Six patients underwent robotic surgery, 20 underwent laparoscopic surgery, 8 underwent Laparoscopic-assisted vaginal hysterectomy, and 2 underwent vaginal hysterectomy. 23% (63.9%) patients had high-grade (i.e. 2 and 3) tumors. Among the 36 patients who underwent lymph node sampling, the median number of lymph nodes retrieved was 32 (range 9–57 nodules). No patient (0%) was diagnosed with lymph node metastasis. According to the policy of each institution, 8 patients (22.2%) received adjuvant therapy, and half of them also received chemotherapy (4 patients; 50%). Conclusions None of the patients who met the criteria had a pathological assessment of lymph node metastasis. Omitting lymph node dissection may be reasonable for patients who meet our criteria.

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