{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:55:55Z","timestamp":1791924955346,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001725","name":"Royal Swedish Academy of Sciences","doi-asserted-by":"publisher","award":["ME2019\u20100060"],"award-info":[{"award-number":["ME2019\u20100060"]}],"id":[{"id":"10.13039\/501100001725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Neuroendocrinology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We aimed to assess the prognostic impact of tumor\u2010 and patient\u2010related parameters in patients with stage I\u2013III small intestinal neuroendocrine tumors (SI\u2010NETs), who underwent locoregional resective surgery (LRS) with curative intent. We included 229 patients with stage I\u2013III SI\u2010NETs diagnosed from June 15, 1993, through March 8, 2021, identified using the SI\u2010NET databases from five European referral centers. Mean\u2009\u00b1\u2009SD age at baseline was 62.5\u2009\u00b1\u200913.6\u2009years; 111\/229 patients were women (49.3%). All tumors were well\u2010differentiated; 160 were grade 1 (G1) tumors, 51 were G2, two were G3 and 18 tumors were of unspecified grade (median Ki\u201067: 2%, range 1%\u201350%). One\u2010hundred and sixty\u2010three patients (71.2%) had lymph node (LN) involvement. The median number of retrieved lymph nodes was 10 (0\u201363), whereas the median number of positive LNs was 2 (0\u201343). After a mean\u2009\u00b1\u2009SD follow\u2010up of 54.1\u2009\u00b1\u200964.1\u00a0months, 60 patients experienced disease recurrence at a median (range) of 36.2 (2.5\u2013285.1) months. The 5\u2010 and 10\u2010year recurrence\u2010free survival (RFS) rates were 66.6% and 49.3% respectively. In univariable analysis, there was no difference in RFS and overall survival (OS) between LN\u2010positive and LN\u2010negative patients (log\u2010rank,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.380 and .198, respectively). However, in stage IIIb patients who underwent mesenteric lymph node dissection (MLND) with a minimum of five retrieved LN (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0125), five or more LN metastases were associated with shorter RFS (median RFS [95% CI]\u00a0=\u00a0107.4 [0\u2013229.6] vs. 73.7 [35.3\u2013112.1]\u00a0months; log\u2010rank,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.048). In addition, patients with G2 tumors exhibited shorter RFS compared to patients with G1 tumors (median RFS [95% confidence interval (CI)]\u00a0=\u00a046.9 [36.4\u201357.3] vs. 120.7 [82.7\u2013158.8]\u00a0months; log\u2010rank,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.001). In multivariable Cox\u2010regression RFS analysis in stage IIIb patients, the Ki\u201067 proliferation index (hazard ratio\u00a0=\u00a01.08, 95% CI\u00a0=\u00a01.035\u20131.131;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.0001) and the number of LN metastases (hazard ratio\u00a0=\u00a01.06, 95% CI\u00a0=\u00a01.001\u20131.125;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.047) were independent prognostic factors for RFS. In conclusion, LRS with a meticulous MLND and a minimum number of five harvested LNs appears to be critical in the surgical management of SI\u2010NET patients with locoregional disease. In patients who underwent LRS and MLND, the Ki\u201067 proliferation index and the LN metastases count were independent predictors of RFS.\n                  <\/jats:p>","DOI":"10.1111\/jne.13205","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T06:24:38Z","timestamp":1665210278000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association of lymph node metastases, grade and extent of mesenteric lymph node dissection in locoregional small intestinal neuroendocrine tumors with recurrence\u2010free survival"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4224-8912","authenticated-orcid":false,"given":"Kosmas","family":"Daskalakis","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Second Department of Surgery \"Korgialenio\u2010Benakio\", Red Cross General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Wedin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6013-5893","authenticated-orcid":false,"given":"Marina","family":"Tsoli","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Unit, First Department of Propaupedic Internal Medicine Laiko Hospital, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Kogut","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Neuroendocrine Neoplasms, Department of Endocrinology and Pathophysiology Medical University of Silesia  Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Srirajaskanthan","sequence":"additional","affiliation":[{"name":"ENETS Centre of Excellence, Neuroendocrine Tumour Unit King\u2032s College Hospital  London UK"},{"name":"Department of Gastroenterology King\u2032s College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Sarras","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology King\u2032s College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajith","family":"Kattiparambil","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology King\u2032s College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Giovos","sequence":"additional","affiliation":[{"name":"The ARDEN NET Centre European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin O.","family":"Weickert","sequence":"additional","affiliation":[{"name":"The ARDEN NET Centre European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Kos\u2010Kudla","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Neuroendocrine Neoplasms, Department of Endocrinology and Pathophysiology Medical University of Silesia  Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kaltsas","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Unit, First Department of Propaupedic Internal Medicine Laiko Hospital, National and Kapodistrian University of Athens  Athens 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