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The Distal Predilection of Small Bowel Neuroendocrine Tumors.
Keck, Kendall J; Maxwell, Jessica E; Utria, Alan F; Bellizzi, Andrew M; Dillon, Joseph S; O'Dorisio, Thomas M; Howe, James R.
Afiliação
  • Keck KJ; Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
  • Maxwell JE; Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
  • Utria AF; Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
  • Bellizzi AM; Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
  • Dillon JS; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
  • O'Dorisio TM; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
  • Howe JR; Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA. james-howe@uiowa.edu.
Ann Surg Oncol ; 25(11): 3207-3213, 2018 Oct.
Article em En | MEDLINE | ID: mdl-30054825
ABSTRACT

BACKGROUND:

The small bowel (SB) is the most common site of neuroendocrine tumors (NETs) of the GI tract. These are described as being predominantly jejunoileal, but their exact locations within the SB have not been well defined. We sought to determine prospectively the spectrum of SBNET locations.

METHODS:

Patients undergoing exploration for SBNET primaries had measurement of bowel length, tumor locations, and resection length recorded. Correlations of clinicopathologic factors were performed, and analysis done utilizing Welch's t test, Chi square test, and the Kaplan-Meier method.

RESULTS:

Measurements were recorded in 123 patients, 107 of whom had complete information. Multifocal tumors (MTs) were found in 69 (56%) and unifocal (UTs) in 54 (44%) patients. Only 1 of 107 patients had a tumor within 100 cm of the ligament of Treitz (LT), whereas 77 of 107 (72%) had tumors within 100 cm of the ileocecal valve (ICV). No MTs were found within 100 cm of LT, whereas 41 of 60 (68%) patients had all (10) or at least one tumor (31) located within 100 cm of the ICV. MTs required a mean resection length of 108 versus 59 cm for UTs (p < 0.01). Seventy-seven percent of UTs (36/47) were within 100 cm of ICV. Tumors occurring only between > 100 cm from the LT and ICV were seen in 29 of 107 (27%) patients.

CONCLUSIONS:

SBNETs are frequently multifocal and most commonly located within 100 cm of the ICV. SBNETs are less prevalent proximally in the small bowel, which may result from anatomic differences in enterochromaffin cell density, hormonal factors, or environmental exposures in the distal SB.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Neoplasias Gástricas / Tumores Neuroendócrinos / Neoplasias Intestinais / Intestino Delgado Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Neoplasias Gástricas / Tumores Neuroendócrinos / Neoplasias Intestinais / Intestino Delgado Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article