부산대학교 도서관

Simple Summary: Lymphatic (LI), microvascular (VI) and perineural invasion (PnI) have been determined as indicators for aggressive tumor behavior and worse outcome in many solid tumors. In neuroendocrine tumors of the small intestine (siNET), some prognosis-defining factors have been well established, but the role of LI, VI and PnI remains incompletely understood so far. The aim of our retrospective study was to elucidate the role of lymphatic, microvascular and perineural invasion in the oncological outcome in siNET. We found that lymphatic, microvascular and perineural invasion led to earlier disease recurrence and postoperative disease progression. We therefore promote the routine description of these histopathological parameters for considerations on adjuvant treatment and follow-up. For the histopathological work-up of resected neuroendocrine tumors of the small intestine (siNET), the determination of lymphatic (LI), microvascular (VI) and perineural (PnI) invasion is recommended. Their association with poorer prognosis has already been demonstrated in many tumor entities. However, the influence of LI, VI and PnI in siNET has not been sufficiently described yet. A retrospective analysis of all patients treated for siNET at the ENETS Center of Excellence Charité–Universitätsmedizin Berlin, from 2010 to 2020 was performed (n = 510). Patients who did not undergo primary resection or had G3 tumors were excluded. In the entire cohort (n = 161), patients with LI, VI and PnI status had more distant metastases (48.0% vs. 71.4%, p = 0.005; 47.1% vs. 84.4%, p < 0.001; 34.2% vs. 84.7%, p < 0.001) and had lower rates of curative surgery (58.0% vs. 21.0%, p < 0.001; 48.3% vs. 16.7%, p < 0.001; 68.4% vs. 14.3%, p < 0.001). Progression-free survival was significantly reduced in patients with LI, VI or PnI compared to patients without. This was also demonstrated in patients who underwent curative surgery. Lymphatic, vascular and perineural invasion were associated with disease progression and recurrence in patients with siNET, and these should therefore be included in postoperative treatment considerations. [ABSTRACT FROM AUTHOR]