Tumour grade and size predicts spread of pancreatic neuroendocrine tumours (Cure Today, 12 September 2013)

A recent study in JAMA Surgery suggests that tumour grade and size are predictors of spread of pancreatic NETS. This finding could be helpful to surgeons who are planning to operate on patients with pancreatic NETs. The European research team reported on the surgical findings in 181 patients from multiple European NET centres. Of the 55 of the 181 patients had nodal disease at time of presentation.

They identified that tumour grade can help predict the need for lymphadenectomy in patients with non-functioning pancreatic neuroendocrine tumours.

Neuroendocrine tumours can be relatively slow growing tumours with an indolent behaviour when they are limited to the pancreas. However, the presence of nodes often means a worse survival and a higher likelihood of recurrent disease.

This study confirmed these findings, by demonstrating that the 55 patients with nodal disease had a higher five-year mortality than patients without nodal spread (70% vs. 97%). Independent risk factors on multivariate analysis were radiological nodal involvement (odds ratio, 5.52) and G2 versus G1 tumour grade (OR, 4.87).

Using only preoperative available data (and consequently removing grading from the model), radiological diameter beyond 4 cm was an independent predictor (OR, 2.67) as was radiological nodal involvement (OR, 4.73). Another interesting finding, they add, is that the number of metastatic lymph nodes did not affect disease-free survival, which was similar whether patients had one positive node or as many as five.

This finding may be helpful for surgeons when considering the type of surgical resection they are planning to perform for patients with non-functional pancreatic NETs.

Source: Cure Today