RESUMEN
BACKGROUND/AIMS: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a unique subgroup of tumors in the digestive system but with great clinical heterogeneity. The information on clinical characteristics and prognostic factors of Chinese patients is rather limited. METHODOLOGY: We retrospectively analyzed the clinical features, prognostic factors of this disease in a consecutive cohort (N=294) between January 2007 and December 2012. RESULTS: Functioning tumors accounted for 9.2%. Rectum was the most predominant GEP-NETs locations. Abdominal pain occurred in 46.5% patients which was the most common initial symptom. G1, G2 and G3 tumors accounted for 41.5%, 34.7% and 23.8%, respectively. Endoscopy provided the highest detection rate of 95.7%. Consistence between endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNAB) and surgically obtained histological Ki-67 index was 36.4%. Serum CgA test showed a 80.0% consistence with the tissue biopsy. The median follow up duration was 2.8 years (0.02-5.90 years), the median survival was 4.8 years, overall 5-year survival rate was 69.6%. We found colonic localization, tumor size larger than 20 mm, G3 tumor and metastasis were associated with worse outcome (p<0.05). CONCLUSION: We found both consistence and differences in GEP-NETs characteristics between our study and previous reports.
Asunto(s)
Neoplasias Intestinales/patología , Tumores Neuroendocrinos/secundario , Neoplasias Pancreáticas/patología , Neoplasias Gástricas/patología , Adulto , Pueblo Asiatico , Proliferación Celular , China/epidemiología , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico , Endoscopía del Sistema Digestivo , Femenino , Humanos , Neoplasias Intestinales/química , Neoplasias Intestinales/etnología , Neoplasias Intestinales/mortalidad , Neoplasias Intestinales/cirugía , Estimación de Kaplan-Meier , Antígeno Ki-67/análisis , Masculino , Persona de Mediana Edad , Índice Mitótico , Tumores Neuroendocrinos/química , Tumores Neuroendocrinos/etnología , Tumores Neuroendocrinos/mortalidad , Tumores Neuroendocrinos/cirugía , Neoplasias Pancreáticas/química , Neoplasias Pancreáticas/etnología , Neoplasias Pancreáticas/mortalidad , Neoplasias Pancreáticas/cirugía , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/química , Neoplasias Gástricas/etnología , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Factores de Tiempo , Resultado del Tratamiento , Carga TumoralRESUMEN
Three patients with severe acute pancreatitis (SAP) developed into overt abdominal compartment syndrome (ACS) and confirmed or suspected infection of necrotic tissue. We successfully treated these patients by minimally invasive decompression with the assist of laparoscope after the failures of intensive care treatments. This technique we report here may be another safe and effective management for ACS in SAP.