Predictors of lymph node metastases and impact on survival in resected pancreatic neuroendocrine tumors: a single-center experience

Am J Surg. 2014 Nov;208(5):775-780. doi: 10.1016/j.amjsurg.2014.04.003. Epub 2014 Jun 8.

Abstract

Background: Staging for pancreatic neuroendocrine tumors (PNET) considers tumor size and lymph node (LN) status; however, correlation with survival remains unclear.

Methods: A single-institution database of patients with resected PNET was analyzed.

Results: Of the 150 patients, incidentally discovered PNET was the most common presentation (42%). One hundred thirteen patients (75%) had LN data, 32 (28%) with positive LN (LN+). Procedure and tumor size did not predict LN+. Perineural invasion (P = .016) and lymphovascular (P < .001) invasion, however, were more common in LN+. Multivariate analysis showed poor/moderate differentiation predicted LN+. Median follow-up was 52 months and median overall survival was 225 months. Fifty-two patients (35%) developed recurrence and median disease-free survival (DFS) was 74 months. Only poor/moderate differentiation affected DFS.

Conclusions: PNET has an unclear prognosis based on variables factored into stage. In this study, tumor size did not predict LN+; furthermore, LN+ did not impact overall survival or DFS. Tumor differentiation appears to be more important in determining prognosis.

Keywords: Lymph node metastases; Pancreatic neuroendocrine tumor; Survival.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology*
  • Neuroendocrine Tumors / surgery
  • Pancreatectomy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy*
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Young Adult