Nakao Y, Hayashi H, Yamashita YI, Takashi O, Matsumura K, Uemura N, Kitamura F, Itoyama R, Yusa T, Taki K, Miyata T, Higashi T, Nakagawa S, Okabe H, Imai K, Baba H. Risk factors for lymph node metastasis in patients with pancreatic neuroendocrine neoplasms. World J Clin Oncol 2022; 13(6): 520-528 [PMID: 35949434 DOI: 10.5306/wjco.v13.i6.520]
Corresponding Author of This Article
Hiromitsu Hayashi, FACS, MD, PhD, Surgeon, Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan. hhayasi@kumamoto-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Author contributions: Nakao Y, Hayashi H and Yamashita Y designed the research study; Nakao Y, Takashi O, Matsumura K, Uemura N, Kitamura F, Itoyama R, Yusa T, Taki K, Miyata T, Higashi T, Nakagawa S, Okabe H and Imai K performed the research; Yamashita Y and Baba H contributed new reagents and analytic tools; Nakao Y, Hayashi H and Takashi O analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: Institutional Review Board of Kumamoto University (number 1291).
Informed consent statement: Consent was obtained from the patient and family according to Institutional Review Board protocols.
Conflict-of-interest statement: All the authors have no conflicts of interest in association with this study. No financial support was received for the work described in this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: April 10, 2021 Peer-review started: April 10, 2021 First decision: July 6, 2021 Revised: October 24, 2021 Accepted: May 21, 2022 Article in press: May 21, 2022 Published online: June 24, 2022 Processing time: 437 Days and 23.6 Hours
ARTICLE HIGHLIGHTS
Research background
The indications for lymph node (LN) dissection are still controversial.
Research motivation
Over the last decade, minimally invasive surgery such as laparoscopic pancreatic surgery (LPS) has been increasingly performed for pancreatic tumors including pancreatic neuroendocrine neoplasms (PNENs).
Research objectives
The aim of this study was to investigate the risk factors for LN metastasis in PNENs and to select appropriate patients for limited surgery by LPS.
Research methods
From April 2001 to December 2019, 92 patients underwent pancreatic resection for PNENs at Kumamoto University Hospital. Finally, 82 patients were enrolled in this study. Using perioperative factors, we examined the predictive factors for LN metastasis in PNENs.
Research results
Among the 82 patients, the percentage of LN metastasis according to the pathological findings was 12% (10/82 cases). The median tumor size was 12 mm (range: 5-90 mm). The median tumor size in the LN-positive group (37 mm) was significantly larger than that in the LN-negative group (12 mm) (P = 0.0001). Multivariate analyses revealed that large tumor size (≥ 20 mm) was an independent risk factor for LN metastasis (odds ratio 16.8, P = 0.0062). In patients with small tumors (≤ 10 mm), LN metastasis was not found.
Research conclusions
Large tumor size (≥ 20 mm) is an independent risk factor for LN metastasis in PNENs. In smaller PNENs (≤ 10 mm), we may be able to choose limited surgery without LN dissection.
Research perspectives
In smaller PNENs (≤ 10 mm), we may be able to choose limited surgery without LN dissection.
