Prognostic importance of lymph node yield after curative resection of gastroenteropancreatic neuroendocrine tumours

作     者：Jaseela Chiramel Rose Almond Astrid Slagter Adeel Khan Xin Wang Kok Haw Jonathan Lim Melissa Frizziero Bipasha Chakrabarty Annamaria Minicozzi Angela Lamarca Wasat Mansoor Richard A Hubner Juan William Valle Mairéad Geraldine McNamara 

作者机构：Department of Medical OncologyThe Christie NHS Foundation TrustManchester M204BXUnited Kingdom Royal Free London NHS Foundation TrustLondon NW32QGUnited Kingdom Statistics GroupDigital ServicesThe Christie NHS Foundation TrustManchesterM204BXUnited Kingdom Antoni van Leeuwenhoek/Netherlands Cancer InstituteAmsterdam 1066 CxNetherlands Department of PathologyThe Christie NHS Foundation TrustManchester M204BXUnited Kingdom Department of SurgeryBarts Health NHS TrustLondon EC1A 7BEUnited Kingdom Division of Cancer SciencesUniversity of ManchesterManchester M139PLUnited Kingdom 

出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)

年 卷 期：2020年第11卷第4期

页      面：205-216页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Well differentiated neuroendocrine tumours Pancreatic neuroendocrine tumours Small intestinal neuroendocrine tumours Ki67 Lymph node ratio Lymph node retrieval Lymph node positivity Relapse-free survival Overall survival 

摘      要：BACKGROUND The prognostic significance of lymph nodes(LNs)metastases and the optimum number of LN yield in gastroenteropancreatic neuroendocrine tumours(GEP NETs)undergoing curative resection is still *** studies have demonstrated that cure rate for patients with GEP NETs can be improved by the resection of the primary tumour and regional lymphadenectomy AIM To evaluate the effect of lymph node(LN)status and yield on relapse-free survival(RFS)and overall survival(OS)in patients with resected GEP *** Data on patients who underwent curative resection for GEP NETs between January 2002 and March 2017 were analysed *** 3 tumours(Ki6720%)were *** Cox proportional hazard models were computed for RFS and OS and assessed alongside cut-point analysis to distinguish a suitable binary categorisation of total LNs retrieved associated with *** A total of 217 patients were included in the *** median age was 59 years(21-97 years)and 51%(n=111)were *** tumour sites were small bowel(42%),pancreas(25%),appendix(18%),rectum(7%),colon(3%),gastric(2%),others(2%).Median follow up times for all patients were 41 mo(95%CI:36-51)and 71 mo(95%CI:63–76)for RFS and OS respectively;50 relapses and 35 deaths were *** were retrieved in 151 *** or more LNs were harvested in 106 patients and LN positivity reported in 114 *** or more positive LNs were detected in 62 *** result of univariate analysis suggested perineural invasion(P=0.0023),LN positivity(P=0.033),LN retrieval of≥8(P=0.047)and localisation(P=0.0049)have a statistically significant association with shorter RFS,but there was no effect of LN ratio on RFS:P=0.1 or OS:P=*** necrosis(P=0.021)and perineural invasion(P=0.016)were the only two variables significantly associated with worse *** the final multivariable analysis,localisation(pancreas HR=27.33,P=0.006,small bowel HR=32.44,P=0.005),and retrieval of≥8 LNs(HR=2.7,P