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学科主题临床医学
Regional Lymphadenectomy Is Indicated in the Surgical Treatment of Pancreatic Neuroendocrine Tumors (PNETs)
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
2014-02-01
DOI10.1097/SLA.0000000000000348
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
WOS记录号WOS:000336247600021
项目编号P30 CA091842 ; 5T32CA00962124
资助机构NCI Cancer Center ; Washington University Surgical Oncology Training grant
引用统计
被引频次:60[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/52855
专题北京大学临床肿瘤学院
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
推荐引用方式
GB/T 7714
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.
APA Hashim, Yassar M..,Trinkaus, Kathryn M..,Linehan, David C..,Strasberg, Steven S..,Fields, Ryan C..,...&Hawkins, William G..(2014).Regional Lymphadenectomy Is Indicated in the Surgical Treatment of Pancreatic Neuroendocrine Tumors (PNETs).ANNALS OF SURGERY,259(2),197-203.
MLA Hashim, Yassar M.,et al."Regional Lymphadenectomy Is Indicated in the Surgical Treatment of Pancreatic Neuroendocrine Tumors (PNETs)".ANNALS OF SURGERY 259.2(2014):197-203.
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