イズモ　ワタル   Izumo Wataru   出雲　渉    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Evaluation of the Significance of Lymphatic, Microvascular and Perineural Invasion in Patients With Pancreatic Neuroendocrine Neoplasms.
掲載誌名	正式名：Cancer diagnosis & prognosis 略　 称：Cancer Diagn Progn ISSNコード：27327787/27327787
掲載区分	国外
巻・号・頁	2(2),pp.150-159
著者・共著者	IZUMO Wataru†, HIGUCHI Ryota, FURUKAWA Toru, YAZAWA Takehisa, UEMURA Shuichiro, MATSUNAGA Yutaro, SHIIHARA Masahiro, TAKAYAMA Yukiko, TAHARA Junko, SHIMIZU Kyoko, TOKUSHIGE Katsutoshi, YAMAMOTO Masakazu
担当区分	筆頭著者,責任著者
発行年月	2022
概要	BACKGROUND:Some prognostic factors for pancreatic neuroendocrine neoplasms (PanNENs) have been reported; however, the significance of lymphatic, microvascular, and perineural invasion remains unclear. We aimed to clarify the role of these factors in PanNEN recurrence.PATIENTS AND METHODS:We analyzed 138 patients who underwent curative pancreatectomy and were pathologically diagnosed with PanNEN. We evaluated the association between clinicopathological factors and the recurrence of PanNENs.RESULTS:The numbers of patients with lymphatic, microvascular, and perineural invasion were 34 (25%), 43 (31%) and 17 (12%), respectively. Twenty-four patients (17%) had recurrences, and the 3, 5, and 10-year recurrence-free survival (RFS) rates were 88%, 84%, and 76%, respectively. The recurrence sites (with duplication) were mainly the liver (twenty-two patients), followed by the lymph nodes (seven patients), and bone (two patients). In multivariate analyses, grade 2-3 and the presence of microvascular invasion were significant risk factors for RFS (hazard ratio=7.5 and 7.9, respectively). When examining outcomes according to these factors, the 5-year RFS rates of patients with risk scores of 0, 1, and 2 were 100%, 91%, and 32%, respectively (p<0.001). Even in patients with grade 1 (n=97) or limited resection (enucleation, splenic-preserving distal pancreatectomy, central pancreatectomy, and duodenum-preserving pancreatic head resection, n=62), the presence of microvascular invasion was a significant risk factor for RFS (hazard ratio=13.4 and 18.0, respectively).CONCLUSION:The presence of microvascular invasion is an independent risk factor for recurrence in patients with PanNEN.
DOI	10.21873/cdp.10089
PMID	35399168