Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma

D. K. Bartsch, J. Waldmann, V. Fendrich, L. Boninsegna, C. L. Lopez, S. Partelli, M. Falconi

Research output: Contribution to journalArticle

Abstract

Background: The study was undertaken to determine prognostic factors and the value of systematic lymphadenectomy on survival in sporadic gastrinoma. Methods: Patients with sporadic gastrinoma who underwent initial surgery during a 21-year period in two tertiary referral centres were analysed retrospectively with respect to clinical characteristics, operative procedures and outcome. Results: Forty-eight patients with a median age of 52 (range 22-73) years were analysed. Some 18 patients had pancreatic and 26 had duodenal gastrinomas, whereas the primary tumour remained unidentified in four patients. After a median postoperative follow-up of 83 (range 3-296) months, 20 patients had no evidence of disease, 13 patients were alive with disease, 11 patients had died from the disease and four had died from unrelated causes. In 41 patients who underwent potentially curative surgery, systematic lymphadenectomy with excision of more than ten lymph nodes resulted in a higher rate of biochemical cure after surgery than no or selective lymphadenectomy (13 of 13 versus 18 of 28 patients; P = 0·017), with a trend towards prolonged disease specific survival (P = 0·062) and disease-free survival (P = 0·120), and a reduced risk of death (0 of 13 versus 7 of 24 patients; P = 0·037). Negative prognostic factors for disease specific survival were pancreatic location (P = 0·029), tumour size equal to or larger than 25 mm (P = 0·003), Ki-67 index more than 5 per cent (P <0·001), preoperative gastrin level 3000 pg/ml or more (P = 0·003) and liver metastases (P <0·001). Sex, age, type of surgery and presence of lymph node metastases had no influence on disease free or disease specific survival. Conclusion: In sporadic gastrinoma, systematic lymphadenectomy during initial surgery may reduce the risk of persistent disease and improve survival.

Original languageEnglish
Pages (from-to)1234-1240
Number of pages7
JournalBritish Journal of Surgery
Volume99
Issue number9
DOIs
Publication statusPublished - Sep 2012

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Gastrinoma
Lymph Node Excision
Survival
Lymph Nodes
Neoplasm Metastasis
Gastrins
Operative Surgical Procedures
Tertiary Care Centers
Disease-Free Survival
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Bartsch, D. K., Waldmann, J., Fendrich, V., Boninsegna, L., Lopez, C. L., Partelli, S., & Falconi, M. (2012). Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma. British Journal of Surgery, 99(9), 1234-1240. https://doi.org/10.1002/bjs.8843

Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma. / Bartsch, D. K.; Waldmann, J.; Fendrich, V.; Boninsegna, L.; Lopez, C. L.; Partelli, S.; Falconi, M.

In: British Journal of Surgery, Vol. 99, No. 9, 09.2012, p. 1234-1240.

Research output: Contribution to journalArticle

Bartsch, DK, Waldmann, J, Fendrich, V, Boninsegna, L, Lopez, CL, Partelli, S & Falconi, M 2012, 'Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma', British Journal of Surgery, vol. 99, no. 9, pp. 1234-1240. https://doi.org/10.1002/bjs.8843
Bartsch DK, Waldmann J, Fendrich V, Boninsegna L, Lopez CL, Partelli S et al. Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma. British Journal of Surgery. 2012 Sep;99(9):1234-1240. https://doi.org/10.1002/bjs.8843
Bartsch, D. K. ; Waldmann, J. ; Fendrich, V. ; Boninsegna, L. ; Lopez, C. L. ; Partelli, S. ; Falconi, M. / Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma. In: British Journal of Surgery. 2012 ; Vol. 99, No. 9. pp. 1234-1240.
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