Impact of tumor size and nodal status on recurrence of nonfunctional pancreatic neuroendocrine tumors =2cm after curative resection: A multi-institutional study of 392 cases. Journal of surgical oncology Dong, D., Zhang, X., Poultsides, G., Rocha, F., Weber, S., Fields, R., Idrees, K., Cho, C., Maithel, S. K., Pawlik, T. M., other members of the US Neuroendocrine Tumor Study Group 2019


BACKGROUND: The current study sought to define the impact of lymph node metastasis (LNM) relative to tumor size on tumor recurrence after curative resection for nonfunctional pancreatic neuroendocrine tumors (NF-pNETs) =2cm.METHODS: Patients who underwent curative resection for =2-cm NF-pNETs were identified from a multi-institutional database. Risk factors associated with tumor recurrence as well as LNM were identified. Recurrence-free survival (RFS) was compared among patients with or without LNM.RESULTS: A total of 392 =2-cm NF-pNETs patients were identified. Among the 328 patients who had lymph node dissection and evaluation, 42 (12.8%) patients had LNM. LNM was associated with tumor recurrence (hazard ratio, 3.06; P=.026) after surgery. RFS was worse among LNM vs no LNM patients (5-year RFS, 81.7% vs 94.1%; P=.019). Patients with tumors measuring 1.5-2cm had a two-fold increase in the incidence of LNM vs patients with tumors <1.5cm (17.9% vs 8.7%, odds ratio, 2.59; P=.022), as well as a higher risk of advanced tumor grade and higher Ki-67 levels (both P<.01). After curative resection, a total of 14 (8.0%) patients with a tumor of 1.5-2cm and 10 (4.5%) patients with tumor <1.5cm developed tumor recurrence.CONCLUSION: Surgical resection with lymphadenectomy should be considered for patients with NF-pNETs =1.5-2.0cm.

View details for DOI 10.1002/jso.25716

View details for PubMedID 31571225