Pancreatic NETs: no survival benefit for lymph node dissection

  • Mao R & al.
  • Ann Surg Oncol
  • 17.06.2019

  • von Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • An analysis of the National Cancer Database (NCDB) shows that lymph node dissection (LND) provides no survival benefit for patients with pancreatic neuroendocrine tumors (pNETs).

Why this matters

  • Current guidelines recommend lymph node dissection in pNETs, but there is little evidence supporting this position.

Study design

  • Retrospective analysis of the NCDB (n=2644).
  • Funding: National Natural Science Foundation of China; Chinese Academy of Medical Sciences; Capital Health Research and Development of Special.

Key results

  • An inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier analysis revealed a similar median OS between LND and non-LND groups (152.8 vs 147.3 months; P=.61).
  • The groups had similar OS:
    • 5-year OS: 91.2% LND vs 89.5% non-LND.
    • 10-year OS: 67.0% LND vs 72.0% non-LND.
    • HR, 1.15; P=.18.
  • Subgroup analyses by clinical T and N stages showed no survival benefit from LND.
  • Among LND patients who had >9 lymph nodes removed vs ≤9, there was a similar median OS (136.2 vs 149.9 months; P=.55) and similar 5- and 10-year OS (>9; HR, 0.82; P=.22).

Limitations

  • Retrospective analysis.