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Background <p>Although the status of lymph node metastasis (LNM) is crucial in determining treatment strategy for duodenal neuroendocrine tumors (D-NETs), robust evidence for their potential LNM risk remains lacking. This systematic review aimed to summarize the prevalence and risk factors of LNM in D-NETs.</p> Methods <p>This systematic review of electronic databases identified eligible case–control and cohort studies for D-NET resected either endoscopically or surgically, published from 1990 to 2023. The primary outcome was the pooled prevalence of LNM in D-NETs. Secondary outcomes included the pooled prevalence of LNM according to tumor location and functionality, as well as identifying pathological risk factors for LNM. Meta-analysis was performed.</p> Results <p>We identified 36 studies that involved 1,396 patients with D-NETs, including 326 with LNM. The pooled prevalence of LNM in D-NETs was 22.7% (95% confidence interval [CI] 17.3–29.2%). The prevalence was high in ampullary/peri-ampullary D-NETs and functional D-NETs (46.8 and 53.3%, respectively), whereas it was low in non-functional, non-ampullary D-NETs (NAD-NETs) (9.5%). Pathological risk factors for LNM in NAD-NETs included tumor size &gt; 10&#xa0;mm (odds ratio [OR] 7.31 [95% CI 3.28–16.31]), tumor invasion into the muscularis propria or deeper (OR 7.79 [3.65–16.61]), lymphovascular invasion (OR 5.67 [2.29–14.06]), and World Health Organization grading of G2 (OR 2.47 [1.03–5.92]).</p> Conclusion <p>Approximately one-fourth of the patients with D-NETs had LNM. Endoscopic resection might be acceptable for non-functional NAD-NETs with diameters of 10&#xa0;mm or less, but additional surgical resection with lymphadenectomy may be recommended for cases exhibiting pathological risk factors.</p>

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Prevalence and risk factors for lymph node metastasis in duodenal neuroendocrine tumors: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月3日

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  • Yohei Ogata,
  • Waku Hatta,
  • Takeshi Kanno,
  • Yutaka Hatayama,
  • Masahiro Saito,
  • Xiaoyi Jin,
  • Tomoyuki Koike,
  • Akira Imatani,
  • Yuhong Yuan,
  • Atsushi Masamune

摘要

Background

Although the status of lymph node metastasis (LNM) is crucial in determining treatment strategy for duodenal neuroendocrine tumors (D-NETs), robust evidence for their potential LNM risk remains lacking. This systematic review aimed to summarize the prevalence and risk factors of LNM in D-NETs.

Methods

This systematic review of electronic databases identified eligible case–control and cohort studies for D-NET resected either endoscopically or surgically, published from 1990 to 2023. The primary outcome was the pooled prevalence of LNM in D-NETs. Secondary outcomes included the pooled prevalence of LNM according to tumor location and functionality, as well as identifying pathological risk factors for LNM. Meta-analysis was performed.

Results

We identified 36 studies that involved 1,396 patients with D-NETs, including 326 with LNM. The pooled prevalence of LNM in D-NETs was 22.7% (95% confidence interval [CI] 17.3–29.2%). The prevalence was high in ampullary/peri-ampullary D-NETs and functional D-NETs (46.8 and 53.3%, respectively), whereas it was low in non-functional, non-ampullary D-NETs (NAD-NETs) (9.5%). Pathological risk factors for LNM in NAD-NETs included tumor size > 10 mm (odds ratio [OR] 7.31 [95% CI 3.28–16.31]), tumor invasion into the muscularis propria or deeper (OR 7.79 [3.65–16.61]), lymphovascular invasion (OR 5.67 [2.29–14.06]), and World Health Organization grading of G2 (OR 2.47 [1.03–5.92]).

Conclusion

Approximately one-fourth of the patients with D-NETs had LNM. Endoscopic resection might be acceptable for non-functional NAD-NETs with diameters of 10 mm or less, but additional surgical resection with lymphadenectomy may be recommended for cases exhibiting pathological risk factors.