The role of regional lymphadenectomy in surgical treatment of nonfunctional pancreatic neuroendocrine tumors

Abstract

Objective To analyze the prognostic importance of lymph node metastasis and the significance of regional lymphadenectomy in surgical treatment of nonfunctional pancreatic neuroendocrine tumors(NF-PanNET). Methods The clinical and pathological data of patients who underwent resection of NF-PanNET in Tianjin Medical University Cancer Institute and Hospital from January 2000 to December 2013 were retrospectively studied. The data included age, sex, tumor location, tumor size, lymph node metastasis, surgical resection margins, pathological grades and followed-up visits. Results Of 75 patients in this study, 16 (21.3%) had lymph node metastases. Patients with larger tumors (>3 cm) and higher tumor gradings (G3) had higher rates of lymph nodal metastasis. The overall 3- and 5-year disease-free survival (DFS) were 92.0% and 89.2% respectively. The 5-year DFS for patients with and without nodal metastasis were 75.0% and 93.0% (P 3 cm), high pathological gradings (G3) and positive surgical resection margins (all P<0.05). Multivariable analysis showed that lymph nodal metastasis and surgical resection margin were independent factors associated with DFS (all P<0.05). Conclusions Patients with NF-PanNET with lymph node metastasis had significantly higher risks of recurrence and metastasis. Patients with large tumor sizes (>3 cm) had a higher rate of lymph node metastasis, and radical surgery with lymph node dissection is recommended for these patients. Key words: Pancreatic neoplasms; Neuroendocrine tumors; Lymph metastasis; Surgical procedures, operative