Recurrence in Patients With Lymph Node-Negative Pancreatic Neuroendocrine Tumors

作者：Marco Ventin, Shahrzad Arya, Liti Zhang, Alexandra Gangi, Carlos Fernandez del-Castillo, Motaz Qadan, Andrew Hendifar, Giulia Cattaneo, Luigi Liguori, Arsen Osipov, Francesco Sabbatino, Nicholas N. Nissen, Kambiz Kosari, Keith D. Lillemoe, Alice C. Wei, Jing He, Amer H. Zureikat, Cristina R. Ferrone · 发表于：JAMA Surgery · 年份：2025 · DOI：10.1001/jamasurg.2025.5401 · 被引用次数：2 · 研究领域：Neuroendocrine Tumor Research Advances、Lung Cancer Research Studies、Pancreatic and Hepatic Oncology Research

Importance: Lymph node (LN) metastasis is a strong predictor of tumor recurrence following pancreatectomy for localized pancreatic neuroendocrine tumors (PanNETs). However, most patients lack LN metastasis and many tumors recur. Tools to guide risk-adapted surveillance in this group are lacking. Objective: To develop and validate a tumor recurrence and survival risk score for patients with LN-negative PanNETs. Design, Setting, and Participants: This retrospective, case-control study of patients with localized PanNETs took place at 5 high-volume US institutions from 2000 to 2023. Inclusion required 8 or more evaluated LNs and negative nodal status. Median follow-up was 50.6 months. These data were analyzed from March 2025 to May 2025. Exposure: Surgical resection of localized PanNETs per clinical guidelines. Main Outcomes and Measures: The primary outcome was tumor recurrence. Independent predictors were identified using multivariable logistic regression and used to construct a 13-point composite risk score. Performance was assessed using C statistics. Kaplan-Meier and log-rank methods evaluated disease-free survival (DFS). Genomic profiling was conducted in an external validation cohort to identify and validate recurrence-associated mutational risk scores. Results: Of 2024 patients, 770 met inclusion criteria. Median age was 58.7 (IQR, 18.4) years; 405 were male (52.6%) and 365 were female (47.4%). Most tumors were sporadic (94.1%), nonfunctional (90.4%), and located in the b...