Journal of Gastroenterology

, Volume 47, Issue 6, pp 678–685

Analysis of lymph node metastasis in pancreatic neuroendocrine tumors (PNETs) based on the tumor size and hormonal production

  • Kosuke Tsutsumi
  • Takao Ohtsuka
  • Yasuhisa Mori
  • Minoru Fujino
  • Takaharu Yasui
  • Shinichi Aishima
  • Shunichi Takahata
  • Masafumi Nakamura
  • Tetsuhide Ito
  • Masao Tanaka
Original Article—Liver, Pancreas, and Biliary Tract



Because of the rarity and variety of pancreatic neuroendocrine tumors (PNETs), there have been few reports regarding the indication for lymph node dissection in patients with these tumors. This study aimed to evaluate the risk of lymph node metastasis of PNETs based on the tumor size and hormonal production.


Data for a total of 66 patients who had PNETs resected at our department between 1987 and 2010 were retrospectively studied. The clinicopathological features, including the disease-specific survival rate, were assessed based on the status of lymph node metastasis at the time of initial surgical resection. Then the cut-off point of tumor size to predict lymph node metastasis was estimated.


There were 12 patients (18%) with lymph node metastasis. The frequency of lymph node metastasis tended to be higher in gastrinomas than that in other tumors (43 vs. 15%; P = 0.08). The size of PNETs with lymph node metastasis was significantly larger than that of the PNETs without metastasis (P = 0.04). The postoperative survival rate in the PNET patients with lymph node metastasis was significantly lower than that in the patients without metastasis (P < 0.0001). Only 2 (8%) of 26 PNETs with a tumor size of <15 mm had lymph node metastasis, and both of these were gastrinomas. On the other hand, 10 (25%) of the remaining 40 PNETs with a tumor size of ≥15 mm had lymph node metastasis. Notably, there were no PNETs with lymph node metastasis in 22 non-gastrinomas with a tumor size of <15 mm.


Non-gastrinomas with a tumor size of ≥15 mm and all gastrinomas would be an indication for pancreatectomy with lymph node dissection.


Pancreatic neuroendocrine tumor (PNET) Lymph node metastasis Gastrinoma Non-gastrinoma 


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Copyright information

© Springer 2012

Authors and Affiliations

  • Kosuke Tsutsumi
    • 1
  • Takao Ohtsuka
    • 1
  • Yasuhisa Mori
    • 1
  • Minoru Fujino
    • 2
  • Takaharu Yasui
    • 1
  • Shinichi Aishima
    • 2
  • Shunichi Takahata
    • 1
  • Masafumi Nakamura
    • 1
  • Tetsuhide Ito
    • 3
  • Masao Tanaka
    • 1
  1. 1.Department of Surgery and Oncology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of Anatomic Pathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  3. 3.Department of Medicine and Bioregulatory Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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