@article{4e2fa8f4a2d94eba980aca5c4cdbcdfd,
title = "Impact of tumor size and nodal status on recurrence of nonfunctional pancreatic neuroendocrine tumors ≤2 cm after curative resection: A multi-institutional study of 392 cases",
abstract = "Background: The current study sought to define the impact of lymph node metastasis (LNM) relative to tumor size on tumor recurrence after curative resection for nonfunctional pancreatic neuroendocrine tumors (NF-pNETs) ≤2 cm. Methods: Patients who underwent curative resection for ≤2-cm NF-pNETs were identified from a multi-institutional database. Risk factors associated with tumor recurrence as well as LNM were identified. Recurrence-free survival (RFS) was compared among patients with or without LNM. Results: A total of 392 ≤2-cm NF-pNETs patients were identified. Among the 328 patients who had lymph node dissection and evaluation, 42 (12.8%) patients had LNM. LNM was associated with tumor recurrence (hazard ratio, 3.06; P =.026) after surgery. RFS was worse among LNM vs no LNM patients (5-year RFS, 81.7% vs 94.1%; P =.019). Patients with tumors measuring 1.5-2 cm had a two-fold increase in the incidence of LNM vs patients with tumors <1.5 cm (17.9% vs 8.7%, odds ratio, 2.59; P =.022), as well as a higher risk of advanced tumor grade and higher Ki-67 levels (both P <.01). After curative resection, a total of 14 (8.0%) patients with a tumor of 1.5-2 cm and 10 (4.5%) patients with tumor <1.5 cm developed tumor recurrence. Conclusion: Surgical resection with lymphadenectomy should be considered for patients with NF-pNETs ≥1.5-2.0 cm.",
keywords = "lymph node metastasis, neuroendocrine tumor, pancreas, surgery, tumor size",
author = "{Other Members of the US Neuroendocrine Tumor Study Group} and Dong, {Ding Hui} and Zhang, {Xu Feng} and George Poultsides and Flavio Rocha and Sharon Weber and Ryan Fields and Kamran Idrees and Cliff Cho and Maithel, {Shishir K.} and Pawlik, {Timothy M.}",
note = "Funding Information: Ding-Hui Dong and Xu-Feng Zhang were supported by the Clinical Research Award of the First Affiliated Hospital of the Xi'an Jiaotong University of China (No. XJTU1AF-CRF-2017-004). The authors appreciate the comprehensive work done by other members of the US Neuroendocrine Tumor Study Group: Dr. Alexandra G. Lopez-Aguiar MD, from Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia; Dr. Eleftherios Makris MD from Department of Surgery, Stanford University, Palo Alto, California; Dr. Zaheer Kanji MD from Department of Surgery, Virginia Mason Medical Center, Seattle, Washington; Dr. Alexander Fisher MD from Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Dr. Bradley A. Krasnick MD from Department of Surgery, Washington University School of Medicine, St. Louis, Wisconsin; Dr. Paula M. Smith MD from Department of Surgery, Vanderbilt University, Nashville, Tennessee; Dr. Megan Beems MD from Department of Surgery, University of Michigan, Ann Arbor, Michigan; and Dr. Mary Dillhoff MD from The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio. Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",
year = "2019",
month = dec,
day = "1",
doi = "10.1002/jso.25716",
language = "English (US)",
volume = "120",
pages = "1071--1079",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "7",
}