TY - JOUR
T1 - Malignant pancreatic neuroendocrine tumour
T2 - Lymph node ratio and Ki67 are predictors of recurrence after curative resections
AU - Boninsegna, Letizia
AU - Panzuto, Francesco
AU - Partelli, Stefano
AU - Capelli, Paola
AU - Fave, Gianfranco Delle
AU - Bettini, Rossella
AU - Pederzoli, Paolo
AU - Scarpa, Aldo
AU - Falconi, Massimo
PY - 2012/7
Y1 - 2012/7
N2 - Introduction: Malignant pancreatic neuroendocrine tumours (PNENs) are generally associated with a good prognosis after radical resection. In other pancreatic malignancies predictors of recurrence and the role of lymph node ratio (LNR) are well known, but both have been scarcely investigated for malignant PNETs. Methods: The prospective database from the surgical Department of Verona University was queried. Clinical and pathological data of all patients with resected malignant PNET between 1990 and 2008 were reviewed. Univariate and multivariate analysis were performed. Results: Fifty-seven patients (male/female ratio = 1) with a median age of 58 years (33-78) entered in the study. Twenty-nine (51%) patients underwent pancreaticoduodenectomy and 28 (49%) distal pancreatectomy. Postoperative mortality was nil with a 37% morbidity rate. There were 36 (63%) patients with lymph node metastases (N1). Of these, 23 (64%) had a lymph node ratio (LNR) >0 and ≤0.20 and 13 (36%) had a LNR >0.20. The median overall survival and the median disease free survival (DFS) were 190 and 80 months, respectively. Recurrent disease was identified in 24 patients (42%) with a 2 and 5-year DFS rate of 82% and 49%, respectively. On multivariate analysis, LNR >0.20 (HR = 2.75) and a value of Ki67 >5% (HR = 3.39) were significant predictors of recurrence (P <0.02). Conclusions: After resection for malignant PNETs, LNR and a Ki67 >5% are the most powerful predictors of recurrence. The presence of these factors should be considered for addressing patients to adjuvant treatment in future clinical trials.
AB - Introduction: Malignant pancreatic neuroendocrine tumours (PNENs) are generally associated with a good prognosis after radical resection. In other pancreatic malignancies predictors of recurrence and the role of lymph node ratio (LNR) are well known, but both have been scarcely investigated for malignant PNETs. Methods: The prospective database from the surgical Department of Verona University was queried. Clinical and pathological data of all patients with resected malignant PNET between 1990 and 2008 were reviewed. Univariate and multivariate analysis were performed. Results: Fifty-seven patients (male/female ratio = 1) with a median age of 58 years (33-78) entered in the study. Twenty-nine (51%) patients underwent pancreaticoduodenectomy and 28 (49%) distal pancreatectomy. Postoperative mortality was nil with a 37% morbidity rate. There were 36 (63%) patients with lymph node metastases (N1). Of these, 23 (64%) had a lymph node ratio (LNR) >0 and ≤0.20 and 13 (36%) had a LNR >0.20. The median overall survival and the median disease free survival (DFS) were 190 and 80 months, respectively. Recurrent disease was identified in 24 patients (42%) with a 2 and 5-year DFS rate of 82% and 49%, respectively. On multivariate analysis, LNR >0.20 (HR = 2.75) and a value of Ki67 >5% (HR = 3.39) were significant predictors of recurrence (P <0.02). Conclusions: After resection for malignant PNETs, LNR and a Ki67 >5% are the most powerful predictors of recurrence. The presence of these factors should be considered for addressing patients to adjuvant treatment in future clinical trials.
KW - Ki67
KW - Lymph node ratio
KW - Pancreatic neuroendocrine tumour
KW - Prognosis
KW - Recurrence
KW - Surgery
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U2 - 10.1016/j.ejca.2011.10.030
DO - 10.1016/j.ejca.2011.10.030
M3 - Article
C2 - 22129889
AN - SCOPUS:84862773475
VL - 48
SP - 1608
EP - 1615
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 11
ER -