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Defining the Role of Lymphadenectomy for Pancreatic Neuroendocrine Tumors: An Eight-Institution Study of 695 Patients from the US Neuroendocrine Tumor Study Group.

Alexandra G Lopez-AguiarMohammad Y ZaidiEliza W BealMary DillhoffJohn G D CannonGeorge A PoultsidesZaheer S KanjiFlavio G RochaPaula Marincola SmithKamran IdreesMegan BeemsClifford S ChoAlexander V FisherSharon M WeberBradley A KrasnickRyan C FieldsKenneth CardonaShishir K Maithel
Published in: Annals of surgical oncology (2019)
Tumor size ≥ 2 cm, proximal location, moderate differentiation, and Ki-67 ≥ 3% are preoperative factors that predict LN positivity in resected non-functional PanNETs. Given the 9-23% incidence of LN metastases in patients without such risk factors, routine regional lymphadenectomy should be considered. PD inherently includes sufficient LN retrieval, while DP should aim to remove seven or more LNs for accurate staging.
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