Recently, an original article entitled "New Nodal Staging for Primary Pancreatic Neuroendocrine Tumors: A Multi-Institutional and National Data Analysis" by the team of Professors Lyu Yi and Zhang Xufeng in the First Affiliated Hospital of Xi’an Jiaotong University was published online inAnnals of Surgery(IF:9.476), which is widely recognized as the most authoritative journal in the field of surgery.
During the surgical treatment of pancreatic neuroendocrine tumors (pNETs), Professors Lyu Yi and Wu Zheng have demonstrated that the number of lymph node metastases probably exerts certain effect upon the clinical prognosis of pNETs patients. The 8thedition AJCC TNM staging of pNETs simply defines the number of lymph node metastasis as N0 (no lymph node metastasis) and N1 (lymph node metastasis). However, no specific suggestions have been given on the influence of the minimum number of resected lymph nodes and the number of positive lymph nodes upon the clinical prognosis. Consequently, Professor Zhang Xufeng from Department of Hepatobiliary Surgery in our hospital cooperated with relevant research teams of pNETs from the United States. Based on 854 cases of pNETs undergoing radical resection from international multi-center, relevant data were statistically analyzed to conclude that at least 8 or more lymph nodes should be resected during pNETs surgery to obtain accurate N staging. According to the number of positive lymph nodes, N stage should be further defined as N0 (no lymph node metastasis), N1 (1-3 lymph nodes metastasis) and N2 (4 lymph nodes metastasis and more). The new staging system has been effectively validated by 2,764 pNETs patients undergoing surgical resection in SEER database, an authoritative cancer statistical database throughout the United States. It will absolutely provide important evidence for the revision and modification of the new-edition TNM staging of pNETs.
Professor Zhang Xufeng is the first author, and Professor Lyu Yi, Dr. Xue Feng and Dr. Dong Dinghui are the co-authors of this article. The First Affiliated Hospital of Xi 'an Jiaotong University is the first affiliation. The cooperative institutions include Ohio State University, Stanford University, Emory University, University of Michigan, Washington University in St. Louis, Virginia Mason, Vanderbilt University and other world-renowned universities.
Link: https://www.ncbi.nlm.nih.gov/pubmed/31356277
