{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:12:57Z","timestamp":1775009577847,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The management of nodal disease remains controversial for small bowel neuroendocrine tumors (SB\u2010NETs). Debates remain regarding the therapeutic role and extent of routine lymph node dissection (LND) for localized SB\u2010NETs, as well as the need for aggressive resection of advanced loco\u2010regional SB\u2010NETs with mesenteric nodal masses. This review will address these questions regarding lymph node dissection for well\u2010differentiated WHO grade 1 and 2 SB\u2010NETs. In general, the aggressiveness and radicality of resection should be balanced against the length of bowel resected and post\u2010operative functional outcomes. In localized SB\u2010NETs with clinically negative lymph nodes, a nodal harvest of\u2009\u2265\u20098 lymph nodes provides accurate staging, but has not been shown to confer survival benefit. For loco\u2010regional SB\u2010NETs with clinically positive lymph nodes identified on imaging, 4 stages of nodal extent have been described: stage 1\u00a0nodes are located near to the intestinal border, stage 2 on arterial branches close to the origin of the SMA, stage 3 along the SMA itself, and stage 4 extend in the retroperitoneum under the pancreatic neck. In SB\u2010NETs, every attempt should be made at resection of the primary tumor and the nodal mesenteric mass for curative\u2010intent management and to prevent debilitating complications from mesenteric fibrosis. A mesenteric\u2010sparing approach is favored to allow for resection for complex proximal nodal masses while preserving intestinal length and function. All patients with SB\u2010NETs with nodal mesenteric mass should be assessed by a surgeon for resection; if deemed unresectable, consideration should be given to assessment in high\u2010volume NETs centres to confirm proximal mesenteric\u2010sparing resection is not feasible.<\/jats:p>","DOI":"10.1007\/s00268-020-05710-z","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T10:02:46Z","timestamp":1596189766000},"page":"197-202","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Extent of Lymph Node Dissection for Small Bowel Neuroendocrine Tumors"],"prefix":"10.1002","volume":"45","author":[{"given":"Julie","family":"Hallet","sequence":"first","affiliation":[{"name":"Department of Surgery University of Toronto Toronto ON Canada"},{"name":"Susan Leslie Clinic for Neuroendocrine Tumors Odette Cancer Centre, Sunnybrook Health Sciences Centre 2075, Bayview avenue, T2\u2010102 M4N 3M5 Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calvin","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Toronto Toronto ON Canada"},{"name":"Susan Leslie Clinic for Neuroendocrine Tumors Odette Cancer Centre, Sunnybrook Health Sciences Centre 2075, Bayview avenue, T2\u2010102 M4N 3M5 Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"The Commonwealth Neuroendocrine Tumours Research Collaborative (CommNETs) Surgical Section","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29099"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0589"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0575"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010232"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/mpa.0000000000000846"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010017\u20103524\u20109"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.04.021"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010002\u20106630\u2010z"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.3865"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000471879"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443170"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20101918\u20108"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7649"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010016\u20103432\u20102"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.05.028"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010011\u20101296\u2010z"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/jop.18.00135"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.2428"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000493317"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","unstructured":"LaskaratosF\u2010M DiamantopoulosL WalkerMet al. 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JH and CL have received speaking honoraria from Ipsen Biopharmaceuticals Canada, Novartis Oncology, and Advanced Accelerated Applications.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}