Prognostic Significance of Lymph Node Yield on Disease-Free Survival and Overall Survival in Patients With Small Bowel Neuroendocrine Tumors.

Background Small bowel neuroendocrine tumors (SB-NETs) are increasingly recognized gastrointestinal neoplasms with distinct biological behavior and a high tendency for lymphatic spread. Accurate pathological staging, particularly lymph node yield (LNY), plays a pivotal role in determining prognosis and guiding treatment strategies. Objective To evaluate the prognostic significance of lymph node yield and other clinicopathological features in relation to disease-free and overall survival in patients with SB-NETs.

Methods

This retrospective study included 62 patients with histologically confirmed SB-NETs treated at a tertiary care center. Demographic data, tumor characteristics, Ki-67 index, presence of metastases, type of surgery, and adjuvant treatment were recorded. Results The mean age at diagnosis was 51.9 ± 10.2 years. There was a male predominance, with 44 (71.0%) patients being male. The most common presenting symptom was abdominal pain, reported in 31 (50.0%) patients. Lymph node metastases were present in 32 (51.6%) patients, while liver metastases were observed in 15 (24.2%) patients. The most frequent primary tumor site was the duodenum, found in 28 (45.2%) patients. A low Ki-67 index (≤2%) was observed in 27 (43.5%) cases. Surgical resection was performed in the majority, with laparotomy being the most common approach in 36 (58.1%) patients. Adjuvant therapy was administered to 20 (32.3%) patients. Conclusion It is concluded that lymph node yield is a key prognostic factor in SB-NETs and should be emphasized in surgical planning. Nodal and liver metastases are common at presentation, underscoring the need for comprehensive staging.