Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors
Background Neuroendocrine tumors of the small intestine commonly metastasize to regional lymph nodes (LNs). Single-institution reports suggest that removal of LNs improves outcome, but comprehensive data are lacking. We hypothesized that the extent of lymphadenectomy reported in a large administrati...
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2013
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| Online Access: | http://hdl.handle.net/10725/2639 http://dx.doi.org/10.1007/s00268-013-1918-8 http://link.springer.com/article/10.1007/s00268-013-1918-8 |
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| _version_ | 1864513459016695808 |
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| author | Landry, Christine |
| author2 | Lin, Heather Phan, Alexandria Charnsangavej, Chusilp Abdalla, Eddie Aloia, Thomas Vauthey, Jean-Nicolas Katz, Matthew Yao, James Fleming, Jason |
| author2_role | author author author author author author author author author |
| author_facet | Landry, Christine Lin, Heather Phan, Alexandria Charnsangavej, Chusilp Abdalla, Eddie Aloia, Thomas Vauthey, Jean-Nicolas Katz, Matthew Yao, James Fleming, Jason |
| author_role | author |
| dc.creator.none.fl_str_mv | Landry, Christine Lin, Heather Phan, Alexandria Charnsangavej, Chusilp Abdalla, Eddie Aloia, Thomas Vauthey, Jean-Nicolas Katz, Matthew Yao, James Fleming, Jason |
| dc.date.none.fl_str_mv | 2013 2015-11-20T07:46:53Z 2015-11-20T07:46:53Z 2015-11-20 |
| dc.identifier.none.fl_str_mv | 0364-2313 http://hdl.handle.net/10725/2639 http://dx.doi.org/10.1007/s00268-013-1918-8 Landry, C. S., Lin, H. Y., Phan, A., Charnsangavej, C., Abdalla, E. K., Aloia, T., ... & Fleming, J. B. (2013). Resection of at-risk mesenteric lymph nodes is associated with improved survival in patients with small bowel neuroendocrine tumors. World journal of surgery, 37(7), 1695-1700. http://link.springer.com/article/10.1007/s00268-013-1918-8 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | World Journal of Surgery |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background Neuroendocrine tumors of the small intestine commonly metastasize to regional lymph nodes (LNs). Single-institution reports suggest that removal of LNs improves outcome, but comprehensive data are lacking. We hypothesized that the extent of lymphadenectomy reported in a large administrative database would be associated with overall survival for jejunal and ileal neuroendocrine tumors. Methods A search of the Surveillance Epidemiology and End Results database was performed for patients with jejunal and ileal neuroendocrine tumors from 1977 to 2004. Descriptive patient characteristics were collected to include age at diagnosis, sex, race, grade, primary tumor size, LN status, number of LNs resected, presence of distant metastasis, and the type of operation. Statistical analyses were limited to patients with only one primary tumor to exclude patients with other malignancies. Univariate and multivariate analyses were performed to analyze the number of LNs resected and the LN ratio (number of positive LNs/total number of LNs removed) to determine the effect on cancer-specific survival. Results Altogether, 1,364 patients were included in this analysis. Removal of any LNs was associated with improved cancer-specific survival when compared to patients with no LN removal reported (p = 0.0027) on univariate analysis. Among those who had any LNs removed, a median of eight LNs were identified in resection specimens with a median LN ratio of 0.29 (range 0–1). On multivariate analysis (adjusting for age and tumor size), patients with >7 LNs removed experienced better cancer-specific survival than those with ≤7 LNs removed (median survival not reached vs. 140 months): hazard ratio and 95 % confidence interval were 0.573 (0.402, 0.817) (p = 0.002). Conclusions This review of a large number of surgical patients demonstrates that regional mesenteric lymphadenectomy in conjunction with resection of the primary tumor is associated with improved survival of patients with small bowel neuroendocrine tumors. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_2e289a550bc01ab92dedf3c16eb31274 |
| identifier_str_mv | 0364-2313 Landry, C. S., Lin, H. Y., Phan, A., Charnsangavej, C., Abdalla, E. K., Aloia, T., ... & Fleming, J. B. (2013). Resection of at-risk mesenteric lymph nodes is associated with improved survival in patients with small bowel neuroendocrine tumors. World journal of surgery, 37(7), 1695-1700. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2639 |
| publishDate | 2013 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine TumorsLandry, ChristineLin, HeatherPhan, AlexandriaCharnsangavej, ChusilpAbdalla, EddieAloia, ThomasVauthey, Jean-NicolasKatz, MatthewYao, JamesFleming, JasonBackground Neuroendocrine tumors of the small intestine commonly metastasize to regional lymph nodes (LNs). Single-institution reports suggest that removal of LNs improves outcome, but comprehensive data are lacking. We hypothesized that the extent of lymphadenectomy reported in a large administrative database would be associated with overall survival for jejunal and ileal neuroendocrine tumors. Methods A search of the Surveillance Epidemiology and End Results database was performed for patients with jejunal and ileal neuroendocrine tumors from 1977 to 2004. Descriptive patient characteristics were collected to include age at diagnosis, sex, race, grade, primary tumor size, LN status, number of LNs resected, presence of distant metastasis, and the type of operation. Statistical analyses were limited to patients with only one primary tumor to exclude patients with other malignancies. Univariate and multivariate analyses were performed to analyze the number of LNs resected and the LN ratio (number of positive LNs/total number of LNs removed) to determine the effect on cancer-specific survival. Results Altogether, 1,364 patients were included in this analysis. Removal of any LNs was associated with improved cancer-specific survival when compared to patients with no LN removal reported (p = 0.0027) on univariate analysis. Among those who had any LNs removed, a median of eight LNs were identified in resection specimens with a median LN ratio of 0.29 (range 0–1). On multivariate analysis (adjusting for age and tumor size), patients with >7 LNs removed experienced better cancer-specific survival than those with ≤7 LNs removed (median survival not reached vs. 140 months): hazard ratio and 95 % confidence interval were 0.573 (0.402, 0.817) (p = 0.002). Conclusions This review of a large number of surgical patients demonstrates that regional mesenteric lymphadenectomy in conjunction with resection of the primary tumor is associated with improved survival of patients with small bowel neuroendocrine tumors.PublishedN/A2015-11-20T07:46:53Z2015-11-20T07:46:53Z20132015-11-20Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0364-2313http://hdl.handle.net/10725/2639http://dx.doi.org/10.1007/s00268-013-1918-8Landry, C. S., Lin, H. Y., Phan, A., Charnsangavej, C., Abdalla, E. K., Aloia, T., ... & Fleming, J. B. (2013). Resection of at-risk mesenteric lymph nodes is associated with improved survival in patients with small bowel neuroendocrine tumors. World journal of surgery, 37(7), 1695-1700.http://link.springer.com/article/10.1007/s00268-013-1918-8enWorld Journal of Surgeryinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26392019-02-26T10:50:39Z |
| spellingShingle | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors Landry, Christine |
| status_str | publishedVersion |
| title | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| title_full | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| title_fullStr | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| title_full_unstemmed | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| title_short | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| title_sort | Resection of At-Risk Mesenteric Lymph Nodes Is Associated with Improved Survival in Patients with Small Bowel Neuroendocrine Tumors |
| url | http://hdl.handle.net/10725/2639 http://dx.doi.org/10.1007/s00268-013-1918-8 http://link.springer.com/article/10.1007/s00268-013-1918-8 |