title: The role of lymph node ratio in recurrence after curative surgery for pancreatic endocrine tumours.
abstract: BACKGROUND
  The prognostic role of lymph nodes metastasis in pancreatic neuroendocrine tumours is unclear.
  
  
  METHODS
  Retrospective study of 53 patients who underwent a curative standard resection for pancreatic neuroendocrine tumours. The endpoint was to define the role of the lymph nodes ratio in recurrence after curative surgery. The following data were considered as possible factors for predicting the risk of recurrence: gender, age, presence of symptoms, hormonal status, site of tumours, type of resection, size of the tumours, radical resection, pathological T, N and M stage, the Ki67 index, the number of lymph nodes harvested, the number of metastatic lymph nodes and the lymph node ratio. Recurrence rate and time of recurrence were evaluated.
  
  
  RESULTS
  Twelve (26.4%) patients developed a recurrence with a median time of 42.8 (1-305) months. At multivariate analysis, the only factors related to recurrence were: size of lesions (HR 1.1, C.I. 95% 1.0-1.1, P = 0.011), Ki67 ≥ 5% (HR 3.6, C.I. 95% 1.3-10, P = 0.014) and LNR > 0.07 (HR 5.2, C.I. 95% 1.1-25, P = 0.045).
  
  
  CONCLUSIONS
  Our study confirmed that the lymph nodes ratio played an important role in the recurrence rate and suggested that a low number of metastatic lymph nodes reduced the disease free survival.
authors.affiliation: Department of Internal Medicine, Emergency and Surgery (DIMES), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Italy. Electronic address: claudiochir@gmail.com.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ricci
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casadei
authors.forename: Giovanni
authors.initials: G
authors.lastname: Taffurelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Buscemi
authors.forename: Marielda
authors.initials: M
authors.lastname: D'Ambra
authors.forename: Francesco
authors.initials: F
authors.lastname: Monari
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
authors.forename: Davide
authors.initials: D
authors.lastname: Campana
authors.forename: Paola
authors.initials: P
authors.lastname: Tomassetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Minni
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018358:Neuroendocrine Tumors / Q000473:pathology* / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D019394:Ki-67 Antigen
keywords: Lymph nodes; Neuroendocrine tumours; Pancreatic neoplasm