Prognostic Effect of Lymph Node Metastases and Mesenteric Deposits in Neuroendocrine Tumors of the Small Bowel
| Autor: | Federica Grillo, Manuela Albertelli, Pasqualino Malandrino, Andrea Dotto, Genoveffa Pizza, Giuseppe Cittadini, Annamaria Colao, Antongiulio Faggiano |
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| Rok vydání: | 2021 |
| Předmět: |
Extranodal Extension
mesenteric tumor deposits Endocrinology Diabetes and Metabolism Biochemistry (medical) Clinical Biochemistry Prognosis Biochemistry ileum lymph node metastases lymph node ratio neuroendocrine tumor small bowel Neuroendocrine Tumors Endocrinology Lymphatic Metastasis Humans Lymph Node Excision Lymph Nodes Retrospective Studies |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 107(12) |
| ISSN: | 1945-7197 |
| Popis: | Well-differentiated, low-grade neuroendocrine tumors (NETs) are the most frequent tumor types of the small bowel. Despite their generally indolent growth patterns and grade, these tumors tend to metastasize; indeed, at presentation, approximately 50% show nodal metastases and 30% of patients have distant metastases, even though they potentially show long survival. Little is available in the literature concerning the optimal nodal yield in small-bowel resections, and the clinical significance of nodal metastases and lymph node ratio (LNR) at this site is still debated. The aim of this review, through a systematic literature search, is to explore and analyze data regarding nodal status, adequacy of lymphadenectomy, and LNR on the prognosis of small bowel NETs using defined end points (progression-free survival, recurrence-free survival, and overall survival). Some surgical series have demonstrated that extended regional mesenteric lymphadenectomy, together with primary tumor resection, is associated with improved patient survival, and LNR is proving a prognostically important parameter. The new feature of mesenteric tumor deposits (MTDs; neoplastic deposits found in the mesenteric perivisceral adipose tissue that are not LN associated) seems to be a better prognostic predictor in small-bowel NETs compared to nodal metastases, and this feature is explored and critiqued in this review. In particular, increasing number of tumor deposits is correlated with increased risk of disease-specific death, and MTDs seem to correlate with peritoneal carcinomatosis. |
| Databáze: | OpenAIRE |
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