Clinical features and outcomes of gastric neuroendocrine tumors after endoscopic diagnosis and treatment: A Digestive Endoscopy Society of Tawian (DEST).
Medicine (Baltimore)
; 97(38): e12101, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-30235663
ABSTRACT
Gastric neuroendocrine tumors (GNETs) are a heterogeneous group of neoplasm with varying biological characteristics. This study aimed to investigate the clinical features and outcomes of GNET patients after endoscopic diagnosis and treatment in a multicenter registry. Patients with GNETs confirmed histologically were recruited from 17 hospitals between January 2010 and April 2016 in Taiwan. Clinical, laboratory, radiological, endoscopic, pathological data, treatment strategies, follow-up periods, and survivals were collected retrospectively. Totally 187 (107 female, 80 male) patients were recruited. Mean (â±âstandard deviation [SD]) age and size of tumors were 63.2-year-old (â±â14.6) and 2.3-cm (â±â3.0). World Health Organization (WHO) grading were 93 (49.7%) G1, 26 (13.9%) G2, 40 (21.4%) G3, and 28 (15.0%) unknown. G3 patients were older (meanâ±âSD, 71.6â±â12.4 vs. 60.9â±â14.3/56.7â±â15.4 years), larger (6.1â±â4.0 vs.1.2â±â1.3/2.4â±â2.5âcm), more distally located (35.0% vs. 7.6%/15.4%), lower proportion of superficial lesions (17.5% vs. 61.9%/53.8%) and higher rates of lymphovascular invasion (32.5% vs. 3.2%/7.7%) than G1/G2. There was no nodal or distant organ metastases despite different grading of lesionsâ¦10âmm and those <20âmm limited to mucosa and submucosa layers. GNETs larger than 20âmm with G1, G2, and G3 had lymph node (LN) metastatic rates of 21.4%, 30.0%, and 59.3%, respectively. Survivals were different between grading for those >20âmm (log-rank test Pâ=â.02). Male gender (Pâ=â.01), deeper invasion (Pâ=â.0001), nodal (Pâ<â.0001), and distant organ metastases (Pâ=â.0001) were associated with worse outcome. In conclusion, treatment strategies for GNET should be decided by grading, size, invasiveness, and LN metastasis risk. Curative endoscopic resection is feasible for G1/2 lesions less than 20âmm and limited to mucosa/submucosa layers without lymphovascular invasion.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
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Endoscopia Gastrointestinal
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Tumores Neuroendócrinos
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Medicine (Baltimore)
Ano de publicação:
2018
Tipo de documento:
Article