Prognostic Factors of Small Non-Functional Pancreatic Neuroendocrine Tumors and the Risk of Lymph Node Metastasis: A Population-Level Study

作者全名："Tan, Qingquan; Wang, Xing; Li, Yichen; Liu, Yingyi; Liu, Xubao; Ke, Nengwen"

作者地址："[Tan, Qingquan; Wang, Xing; Li, Yichen; Liu, Xubao; Ke, Nengwen] Sichuan Univ, West China Hosp, Dept Pancreat Surg, Chengdu, Peoples R China; [Liu, Yingyi] Chongqing Med Univ, Clin Coll 1, Chongqing, Peoples R China"

通信作者："Liu, XB; Ke, NW (通讯作者)，Sichuan Univ, West China Hosp, Dept Pancreat Surg, Chengdu, Peoples R China."

来源：FRONTIERS IN ENDOCRINOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000829444600001

JCR分区：Q1

影响因子：5.2

年份：2022

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：small tumors; non-functional; pancreatic neuroendocrine tumors; lymph node metastasis; prognosis; SEER

摘要："BackgroundSmall non-functional neuroendocrine tumors (NF-PNETs) are a heterogeneous subset of tumors with controversy regarding their optimal management. We aimed to analyze the prognostic factors of patients with small NF-PNETs and create a risk score for lymph node metastasis (LNM). MethodsData of 751 patients with NF-PNETs <= 2 cm were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate survival analysis was performed to analyze the prognostic factors. Logistic regression was used to identify risk factors for LNM. ResultsOf the 751 patients, 99 (13.2%) were confirmed to have LNM. In multivariate survival analysis, LNM (hazard ratio [HR], 2.12; 95% CI, 1.04-4.32, p = 0.040) was independently associated with disease-specific survival. Logistic regression identified that tumor location in the head of the pancreas (odds ratio [OR], 4.33; 95% CI, 2.75-6.81; p < 0.001), size >= 1.5-2 cm (OR, 1.84; 95% CI, 1.17-2.87; p = 0.009), and grade III-IV (OR, 7.90; 95% CI, 1.79-34.90; p = 0.006) were independent risk factors of LNM. According to the OR value, the risk of LNM was scored as follows: a score of 1 for tumors located in the body/tail of the pancreas and 4 for those located in the head; a score of 1 for tumors <1 cm and 2 for those >= 1.5-2 cm; and a score of 1 for tumors with grade I-II and 8 for those with grade III-IV. Finally, the median score for this cohort was 4, with an interquartile range of 3-6. Therefore, patients were classified as three groups based on the risk score system: a total score of 1-3 for low risk, 4-6 for intermediate risk (OR, 2.98; 95% CI, 1.59-5.60; p = 0.001), and 7-14 for high risk (OR, 8.94; 95% CI, 4.50-17.7; p < 0.001), with an incidence of LNM 5.0%, 13.5%, and 31.8%, respectively (p < 0.001). ConclusionSurgical resection with regional lymphadenectomy is recommended for small NF-PNETs with malignant potential of LNM. A risk score for LNM based on tumor grade, location, and size may preoperatively predict LNM of small NF-PNETs and guide clinical practice."

基金机构："Sichuan Province Science and Technology Planning Project [2020YFS0262]; West China Hospital Clinical Research Incubation Project [21HXFH058]; 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project of West China Hospital, Sichuan University [ZY2017302, ZYJC21037]"

基金资助正文："This research was supported by Sichuan Province Science and Technology Planning Project (2020YFS0262), West China Hospital Clinical Research Incubation Project (21HXFH058), and the 1 center dot 3 center dot 5 Project for Disciplines of Excellence-Clinical Research Incubation Project of West China Hospital, Sichuan University (ZY2017302 and ZYJC21037)."