Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 24, 2020; 11(4): 205-216
Published online Apr 24, 2020. doi: 10.5306/wjco.v11.i4.205
Prognostic importance of lymph node yield after curative resection of gastroenteropancreatic neuroendocrine tumours
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
Jaseela Chiramel, Adeel Khan, Kok Haw Jonathan Lim, Melissa Frizziero, Angela Lamarca, Wasat Mansoor, Richard A Hubner, Juan William Valle, Mairéad Geraldine McNamara, Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
Jaseela Chiramel, Royal Free London NHS Foundation Trust, London NW3 2QG, United Kingdom
Rose Almond, Xin Wang, Statistics Group, Digital Services, The Christie NHS Foundation Trust, Manchester, M20 4BX, United Kingdom
Astrid Slagter, Antoni van Leeuwenhoek/Netherlands Cancer Institute, Amsterdam 1066 Cx, Netherlands
Bipasha Chakrabarty, Department of Pathology, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
Annamaria Minicozzi, Department of Surgery, Barts Health NHS Trust, London EC1A 7BE, United Kingdom
Richard A Hubner, Juan William Valle, Mairéad Geraldine McNamara, Division of Cancer Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
Author contributions: Chiramel J wrote the manuscript, drafted conception and designed the study; Almond R and Xin W were in charge of statistical analysis of data; Slagter A, Khan A, and Lim KHJ collected and analysed the data; Frizzero M, Chakrabarty B, Minicozzi A, Lamarca A, Mansoor W, Hubner RA, Valle JW and McNamara MG editing and review the manuscript.
Institutional review board statement: This study was approved by the Quality Improvement and Clinical Audit Committee of The Christie NHS Foundation Trust, Manchester, United Kingdom (reference SE17/2065).
Informed consent statement: Patients were not required to give informed consent to the study. We used anonymous clinical data for the analysis.
Conflict-of-interest statement: The authors report no conflict of interest in this work.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mairéad Geraldine McNamara, BM BCh, MD, MSc, PhD, Attending Doctor, Senior Lecturer, Senior Researcher, Department of Medical Oncology, The Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester M20 4BX, United Kingdom. mairead.mcnamara@christie.nhs.uk
Received: December 24, 2019
Peer-review started: December 24, 2019
First decision: February 20, 2020
Revised: February 29, 2020
Accepted: April 8, 2020
Article in press: April 8, 2020
Published online: April 24, 2020
Processing time: 119 Days and 17 Hours
Core Tip

Core tip: There is no consensus on the optimal number of lymph node (LN) retrieval in patients undergoing resection for gastroenteropancreatic neuroendocrine tumours (GEP NETs). The purpose of this study was to evaluate the LN status and yield on relapse-free survival and overall survival in patients with resected GEP NETs. By using the outcome-oriented approach to cut-point analysis, this study suggested a retrieval of a minimum of eight or more LNs in patients with GEP NETs undergoing curative surgery. The risk of relapse was high in patients who had ≥ 8 LNs retrieved and a high LN yield and LN positivity were seen in small intestinal NETs and pancreatic NETs. The localisation has a significant association with relapse-free survival, necessitating stricter surveillance especially for intestinal NETs and pancreatic NETs.