Prognostic role of examined and positive lymph nodes after distal pancreatectomy for non-functioning neuroendocrine neoplasms

Background The most appropriate nodal staging system for non-functioning pancreatic neuroendocrine tumours (NF-PanNETs) remains unclear. Despite some evidence are available for pancreaticoduodenectomy (PD), the adequate nodal staging is still unknown for distal pancreatectomy (DP). Aim of the present study was to evaluate the prognostic impact of the number of positive lymph nodes after DP for NF-PanNENs and to define the minimal number of lymph nodes to be harvested for an appropriate nodal staging. Methods Data were retrospectively collected from patients who underwent DP with curative intent (R0-R1) for sporadic well-differentiated NF-PanNETs in four Europeans high-volume centers. NF-PanNETs with nodal involvement (N+) were sub-classified into N1 (1 to 3 positive lymph nodes) and N2 (4 or m ore positive lymph nodes). Univariate and multivariate analyses of disease-free survival (DFS) were performed. Results Out of 271 patients in the study, 62 (23%) had nodal involvement (N+). A higher probability of N+ was associated to the following factors: grading, resection margins status, perine ural and microvascular invasion and the number of examined lymph nodes. 3-years DFS rate for N0, N1 and N2 patients was 92%, 72% and 50%, respectively (P
Source: Neuroendocrinology - Category: Endocrinology Source Type: research