Predictors of Lymph Node Metastasis Warranting Lymphadenectomy in Pancreatic Neuroendocrine Tumors | ||
| Ain Shams Journal of Surgery | ||
| Volume 18, Issue 4, October 2025, Pages 328-332 PDF (273.52 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2025.408387.1222 | ||
| Authors | ||
| Walid Akmal Shafie* ; Fouad Abdelshahid Fouad; Islam Ali Soliman; Aly El Faqeh Mohamed Okasha | ||
| Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt | ||
| Abstract | ||
| Introduction: Pancreatic neuroendocrine tumors (PNETs) represent about 1–3% of all pancreatic tumors. The optimal extent of surgical resection remains uncertain, largely due to difficulties in reliably predicting lymph node metastasis (LNM) before surgery—a critical determinant of patient prognosis. Precise preoperative assessment of LNM is essential to guide appropriate surgical planning and minimize unnecessary intervention in patients with a low risk of metastasis. Aim of work: To study the predictor factors of lymph made metastasis in pancreatic neuro endocrine tumour and hence the need for lymphadenectomy. Patients and methods: This retrospective study included patients who underwent curative-intent pancreatic resection for PNETs at the National Cancer Institute, Cairo University, from January 2004 to December 2024. We analyzed associations between LNM and variables including age, tumor size, location, grade, Ki-67 index, lymphovascular invasion (LVI), perineural invasion, and tumor stage. Results: Among 28 patients, 9 (32.1%) had positive lymph nodes. LNM was significantly associated with higher Ki-67 index, grade 2–3 tumors, stage 3–4 disease, LVI, and perineural invasion. No significant association was found between LNM and tumor size, location, or type of surgery. Conclusion: Tumor biology—specifically grade, Ki-67 index, stage, LVI, and perineural invasion—are significant predictors of LNM in PNETs. These factors should guide decisions regarding lymphadenectomy rather than tumor size or location alone. | ||
| Keywords | ||
| Pancreatic neuroendocrine tumor; lymph node metastasis; lymphadenectomy | ||
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