Taki Katsunobu, Hashimoto Daisuke, Nakagawa Shigeki, Ozaki Nobuyuki, Tomiyasu Shinjiro, Ohmuraya Masaki, Arima Kota, Kaida Takayoshi, Higashi Takaaki, Sakamoto Keita, Sakata Kazuya, Okabe Hirohisa, Nitta Hidetoshi, Hayashi Hiromitsu, Chikamoto Akira, Beppu Toru, Takamori Hiroshi, Hirota Masahiko, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto, 861-4193, Japan.
Surg Today. 2017 Sep;47(9):1104-1110. doi: 10.1007/s00595-017-1485-y. Epub 2017 Feb 22.
Pancreatic neuroendocrine tumor (PNET) is relatively rare and has a generally better prognosis than does pancreatic cancer. However, as its prognosis in patients with lymph node metastasis (LNM) is unclear, lymph node dissection for PNET is controversial. Our study aimed to clarify the significance of LNM in PNET.
We retrospectively examined 83 PNET patients who underwent pancreatic resections with lymph node dissection at Kumamoto University Hospital, Saiseikai Kumamoto Hospital, and Kumamoto Regional Medical Center from April 2001 to December 2014. Their clinicopathological parameters were analyzed by the absence or presence of LNM, and with regard to the disease-free survival (DFS) and overall survival (OS). A predictive score of LNM was also made using the age, tumor size, primary tumor location, and tumor function.
Although the 5-year OS was 74.8% for LNM and 94.6% for LNM (P = 0.002), LNM was not an independent risk factor for the OS in a multivariate analysis. However, tumors larger than 1.8 cm were found to be an independent prognostic factor, and the cut-off value for the predictive score was 1.69.
Although LNM was not an independent prognostic factor, lymph node dissection is recommended for patients whose predictive score is larger than 1.69.
胰腺神经内分泌肿瘤（PNET）相对罕见，总体预后较胰腺癌好。然而，由于其在有淋巴结转移（LNM）患者中的预后尚不清楚，PNET的淋巴结清扫存在争议。我们的研究旨在阐明LNM在PNET中的意义。
我们回顾性研究了2001年4月至2014年12月在熊本大学医院、西日本熊本医院和熊本地区医疗中心接受胰腺切除及淋巴结清扫的83例PNET患者。根据有无LNM分析其临床病理参数，并分析无病生存期（DFS）和总生存期（OS）。还使用年龄、肿瘤大小、原发肿瘤位置和肿瘤功能制作了LNM的预测评分。
虽然有LNM患者的5年OS为74.8%，无LNM患者为94.6%（P = 0.002），但在多因素分析中LNM不是OS的独立危险因素。然而，发现肿瘤大于1.8 cm是独立的预后因素，预测评分的临界值为1.69。
虽然LNM不是独立的预后因素，但对于预测评分大于1.69的患者，建议进行淋巴结清扫。
