Preoperative evaluation with computed tomography (CT) of the resectability of mesenteric lymph node metastases in small intestine neuroendocrine neoplasms (si-NENs): New criteria for clinicians and surgeons.

Abstract

212Background: The 2016 European Neuroendocrine Tumor Society consensus guidelines update recommends resection of the primary tumor and all mesenteric lymph-nodes for all patients with si-NENs, both with curative and palliative purposes. Current resectability criteria are based on the degree of involvement of the superior mesenteric artery (SMA) by the metastatic lymph nodes. The aim of this work was to test these criteria for the evaluation of our patients; we included as additional criteria the degree of involvement of the superior mesenteric vein (SMV) and peritoneum, two features not covered by current literature. Methods: We retrospectively reviewed the pre-operative CT-scans of all patients with si-NENs operated at IEO (European Institute of Oncology) between 2008 and April 2018. A first analysis classified tumors as “resectable” or “unresectable” according to SMA involvement. A second analysis classified tumors as resectable or unresectable according to SMA involvement, SMV involvement (infiltratio...