The Role of Alternative Lymph Node Classification Systems in Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NEN): Superiority of a LODDS Scheme Over N Category in Pancreatic NEN (pNEN)
Horm Metab Res 2023; 55: 452-461 DOI: 10.1055/a-2102-7694Lymph node (LN) involvement in gastroenteropancreatic neuroendocrine neoplasms
(GEP-NEN) has been reported to have prognostic and therapeutic implications.
Numerous novel LN classifications exist; however, no comparison of their
prognostic performance for GEP-NEN has been done yet. Using a nationwide cohort
from the German Neuroendocrine Tumor (NET) Registry, the prognostic and
discriminatory power of different LN ratio (LNR) and log odds of metastatic LN
(LODDS) classifications were investigated using multivariate Cox regression and
C-statistics in 671 patients with resected GEP-NEN. An increase in positive LN
(pLN), LNR, and LODDS was associated with advanced tumor stages, distant
metastases, and hormonal functionality. However, none of the alternative LN
classifications studied showed discriminatory superiority in predicting
prognosis over the currently used N category. Interestingly, in a subgroup
analysis, one LODDS classification was identified that might be most appropriate
for patients with pancreatic NEN (pNEN). On this basis, a nomogram was
constructed to estimate the prognosis of pNEN patients after surgery. In
conclusion, a more accurate classification of LN status may allow a more precise
prediction of overall survival and provide the basis for indiv...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Krieg, Sarah Tunk, Johannes Vaghiri, Sascha Prassas, Dimitrios Jann, Henning Mohr, Raphael Loosen, Sven Heiko Roderburg, Christoph Maasberg, Sebastian Begum, Nehara Luedde, Tom Schott, Matthias Giesel, Frederik Knoefel, Wolfram Trudo Krieg, Andreas Tags: Original Article: Endocrine Care Source Type: research
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