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IR@PKUHSC  > 北京大学临床肿瘤学院  > 期刊论文
学科主题: 临床医学
题名:
Regional Lymphadenectomy Is Indicated in the Surgical Treatment of Pancreatic Neuroendocrine Tumors (PNETs)
作者: Hashim, Yassar M.1,2,3; Trinkaus, Kathryn M.4; Linehan, David C.1,2,3; Strasberg, Steven S.1,2,3; Fields, Ryan C.1,2,3; Cao, Dengfeng5,6; Hawkins, William G.1,2,3
关键词: lymphadenectomy ; lymph node metastasis ; pancreatic neuroendocrine tumors
刊名: ANNALS OF SURGERY
发表日期: 2014-02-01
DOI: 10.1097/SLA.0000000000000348
卷: 259, 期:2, 页:197-203
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Surgery
研究领域[WOS]: Surgery
关键词[WOS]: ISLET-CELL TUMORS ; PROGNOSTIC-FACTORS ; ENDOCRINE TUMORS ; RESECTION ; SURVIVAL ; NEOPLASMS ; OUTCOMES ; CLASSIFICATION ; PANCREATICODUODENECTOMY ; COMPLICATIONS
英文摘要:

Objective: To explore the prognostic importance and preoperative predictors of lymph node metastasis in an effort to guide surgical decision making in patients with pancreatic neuroendocrine tumors (PNETs).

Background: PNETs are uncommon, and the natural history of the disease is not well described. As a result, there remains controversy regarding the optimal management of regional lymph nodes during resection of the primary tumor.

Methods: A retrospective review of a prospectively maintained database of patients who underwent surgery for locoregional PNET between 1994 and 2012 was performed. Logistic regression was used to identify predictors of nodal metastasis. Overall survival and disease-free survival were calculated using Kaplan-Meier method. Results were expressed as P values and odds ratio estimates, with 95% confidence intervals.

Results: One hundred thirty-six patients were identified, of whom 50 (38%) patients had nodal metastasis. The frequency of lymph node metastasis was higher for larger tumors [> 1.5 cm (odds ratio [OR] = 4.7)], tumors of the head as compared with body-tail of the pancreas (OR = 2.8), tumors with Ki-67 greater than 20% (OR = 6.7), and tumors with lymph vascular invasion (OR = 3.6) (P < 0.05). Median disease-free survival was lower for patients with nodal metastases (4.5 vs 14.6 years, P < 0.0001).

Conclusions: Lymph node metastasis is predictive of poor outcomes in patients with PNETs. Preoperative variables are not able to reliably predict patients where the probability of lymph node involvement was less than 12%. These data support inclusion of regional lymphadenectomy in patients undergoing pancreatic resections for PNET.

语种: 英语
所属项目编号: P30 CA091842 ; 5T32CA00962124
项目资助者: NCI Cancer Center ; Washington University Surgical Oncology Training grant
WOS记录号: WOS:000336247600021
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/52855
Appears in Collections:北京大学临床肿瘤学院_期刊论文

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作者单位: 1.Barnes Jewish Hosp, Dept Surg, St Louis, MO 63110 USA
2.Barnes Jewish Hosp, Alvin J Siteman Canc Ctr, St Louis, MO 63110 USA
3.Washington Univ, Sch Med, St Louis, MO 63110 USA
4.Washington Univ, Sch Med, Div Biostat, St Louis, MO 63110 USA
5.Washington Univ, Sch Med, Dept Pathol & Immunol, St Louis, MO 63110 USA
6.Peking Univ, Canc Hosp, Minist Educ, Key Lab Carcinogenesis & Translat Res,Dept Pathol, Beijing 100871, Peoples R China

Recommended Citation:
Hashim, Yassar M.,Trinkaus, Kathryn M.,Linehan, David C.,et al. Regional Lymphadenectomy Is Indicated in the Surgical Treatment of Pancreatic Neuroendocrine Tumors (PNETs)[J]. ANNALS OF SURGERY,2014,259(2):197-203.
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