ArticleThe Journal of clinical endocrinology and metabolism2018
A Lymph Node Ratio-Based Staging Model Is Superior to the Current Staging System for Pancreatic Neuroendocrine Tumors.
Article in The Journal of clinical endocrinology and metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- The Role of Alternative Lymph Node Classification Systems in Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NEN): Superiority of a LODDS Scheme Over N Category in Pancreatic NEN (pNEN).Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme · 2023Article
- A Lymph Node Ratio Model for Prognosis of Patients with Pancreatic Neuroendocrine Tumors.Biomedicines · 2023Article
- Risk Stratification of Pancreatic Neuroendocrine Neoplasms Based on Clinical, Pathological, and Molecular Characteristics.Journal of clinical medicine · 2022Review
- Surgical Principles in the Management of Lung Neuroendocrine Tumors: Open Questions and Controversial Technical Issues.Current treatment options in oncology · 2022Review
- Prognostic nomograms for lung neuroendocrine carcinomas based on lymph node ratio: a SEER database analysis.The Journal of international medical research · 2022Article
- A modified mTNM staging system based on lymph node ratio for colon neuroendocrine tumors: A recursive partitioning analysis.Frontiers in surgery · 2022Article
- Prognostic Nomogram Based on the Metastatic Lymph Node Ratio for TFrontiers in oncology · 2022Article
- Role of Lymph Node Resection and Histopathological Evaluation in Accurate Staging of Nonfunctional Pancreatic Neuroendocrine Tumors: How Many Are Enough?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Prognosis analysis of patients with pancreatic neuroendocrine tumors after surgical resection and the application of enucleation.World journal of surgical oncology · 2021Article
- Optimal Cut-Off Values of the Positive Lymph Node Ratio and the Number of Removed Nodes for Patients Receiving Resection of Bronchopulmonary Carcinoids: A Propensity Score-Weighted Analysis of the SEER Database.Frontiers in oncology · 2021Article
- Number of Positive Lymph Nodes Is Superior to LNR and LODDS for Predicting the Prognosis of Pancreatic Neuroendocrine Neoplasms.Frontiers in endocrinology · 2021Article
- Observational
- Prognostic and predictive factors on overall survival and surgical outcomes in pancreatic neuroendocrine tumors: recent advances and controversies.Expert review of anticancer therapy · 2019Review
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Authors and funding
5 authors.
Funding
Abstract
Context: The incidence of pancreatic neuroendocrine tumors (PNETs) is increasing. Current staging systems include nodal positivity, but the association of lymph node status and worse survival is controversial. Objective: The study aim was to determine the prognostic significance of lymph node ratio (LNR) and compare it with nodal positivity for PNET. Design, Setting, Participants, and Intervention: A retrospective analysis of the Surveillance, Epidemiology, and End Results database between 2004 and 2011 was performed in patients who underwent a pancreatectomy with lymphadenectomy. The primary outcome was disease-specific survival (DSS). Results: Of the 896 patients analyzed, T stage, N stage, distant metastasis, grade, extent of resection, sex, and age ≥57 years were significantly associated with worse DSS on univariate analysis. On multivariate analysis, age ≥57 [hazard ratio (HR) 1.75, 95% confidence interval (CI), 1.12 to 2.74, P = 0.015], male sex (HR 1.58; 95% CI, 1.01 to 2.48; P = 0.046), grade (poorly differentiated/undifferentiated: HR 7.59; 95% CI, 4.71 to 12.23; P < 0.001), distant metastases (HR 2.45; 95% CI, 1.58 to 3.79; P < 0.001), and partial pancreatectomy (HR 2.55; 95% CI, 1.2 to 5.4; P = 0.015) were associated with worse DSS. Comparison between staging models constructed based on LNR cutoffs and the American Joint Committee on Cancer (AJCC) eighth edition staging system revealed that a model based on LNR ≥0.5 was superior. Conclusions: LNR ≥0.5 is independently associated with worse DSS. A staging system with LNR ≥0.5 was superior to the current AJCC eighth edition staging system.
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