Wong Joyce, Fulp William J, Strosberg Jonathan R, Kvols Larry K, Centeno Barbara A, Hodul Pamela J
Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
Department of Biostatistics, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
Am J Surg. 2014 Nov;208(5):775-780. doi: 10.1016/j.amjsurg.2014.04.003. Epub 2014 Jun 8.
Staging for pancreatic neuroendocrine tumors (PNET) considers tumor size and lymph node (LN) status; however, correlation with survival remains unclear.
A single-institution database of patients with resected PNET was analyzed.
Of the 150 patients, incidentally discovered PNET was the most common presentation (42%). One hundred thirteen patients (75%) had LN data, 32 (28%) with positive LN (LN+). Procedure and tumor size did not predict LN+. Perineural invasion (P = .016) and lymphovascular (P < .001) invasion, however, were more common in LN+. Multivariate analysis showed poor/moderate differentiation predicted LN+. Median follow-up was 52 months and median overall survival was 225 months. Fifty-two patients (35%) developed recurrence and median disease-free survival (DFS) was 74 months. Only poor/moderate differentiation affected DFS.
PNET has an unclear prognosis based on variables factored into stage. In this study, tumor size did not predict LN+; furthermore, LN+ did not impact overall survival or DFS. Tumor differentiation appears to be more important in determining prognosis.
胰腺神经内分泌肿瘤（PNET）的分期考虑肿瘤大小和淋巴结（LN）状态；然而，与生存率的相关性仍不明确。
分析了一个单机构的PNET切除患者数据库。
150例患者中，偶然发现的PNET是最常见的表现形式（42%）。113例患者（75%）有LN数据，32例（28%）LN阳性（LN+）。手术方式和肿瘤大小不能预测LN+。然而，神经周围侵犯（P = .016）和淋巴管侵犯（P < .001）在LN+患者中更常见。多因素分析显示低/中分化可预测LN+。中位随访时间为52个月，中位总生存期为225个月。52例患者（35%）出现复发，无病生存期（DFS）的中位数为74个月。只有低/中分化影响DFS。
基于分期所考虑的变量，PNET的预后不明确。在本研究中，肿瘤大小不能预测LN+；此外，LN+不影响总生存期或DFS。肿瘤分化在决定预后方面似乎更为重要。
