Endoscopic treatment of sporadic small duodenal and ampullary neuroendocrine tumors.
Endoscopy
; 48(11): 979-986, 2016 Nov.
Article
em En
| MEDLINE
| ID: mdl-27494453
ABSTRACT
Background and study aim:
As duodenal neuroendocrine tumors (NETs) are rare, their optimal management has not been clearly established. The aim of this study was to evaluate the feasibility and outcome of endoscopic treatment of duodenal NETs. Patients andmethods:
We reviewed the files of all patients who underwent endoscopic resection of a sporadic duodenal or ampullary NET between 1996 and 2014âat two centers.Results:
A total of 29 patients with 32 uT1N0M0 NETs <â20âmm were included. Treatment consisted of endoscopic mucosal resection in 19 cases, and cap aspiration in 13 cases. Prior submucosal saline injection was used in 15 cases. Mortality was 3â% (one severe bleeding). Morbidity was 38â% (11/29). At post-resection analysis, mean tumor size was 8.9âmm (range 3â-â17âmm), 29 lesions were stage pT1, one was pT2, and 2 were pTx because of piecemeal resection. All NETs were well differentiated. A total of 27 lesions were classified as grade 1 and 5 were grade 2.âThe resection was R0, R1, and Rx for 16, 14, and 2 lesions, respectively. Three R1 patients underwent additional surgical treatment, with no residual tumor on the surgical specimen but with positive metastatic lymph nodes in two cases. One patient was lost to follow-up.âFinally, 24 patients were included in the follow-up analysis. The median follow-up period was 56 months (range 6â-â175 months). Two patients presented a tumor recurrence during the follow-up period.Conclusions:
Endoscopic treatment of small duodenal NETs was associated with significant morbidity, a difficulty in obtaining an R0 specimen, and the risk of lymph node metastasis. Nevertheless, it represents an interesting alternative in small grade 1 duodenal lesions and in patients at high surgical risk.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tumores Neuroendócrinos
/
Neoplasias do Ducto Colédoco
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Neoplasias Duodenais
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Ressecção Endoscópica de Mucosa
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Recidiva Local de Neoplasia
Tipo de estudo:
Evaluation_studies
Limite:
Adult
/
Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
França