GASTRIC NEUROENDOCRINE TUMOR: WHEN SURGICAL TREATMENT IS INDICATED?

Autor:	Assis Filho AC; Universidade Federal de Jataí - Jataí (GO), Brazil., Tercioti Junior V; Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery and Gastro Center - Campinas (SP), Brazil., Andreollo NA; Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery and Gastro Center - Campinas (SP), Brazil., Ferrer JAP; Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery and Gastro Center - Campinas (SP), Brazil., Coelho Neto JS; Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery and Gastro Center - Campinas (SP), Brazil., Lopes LR; Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery and Gastro Center - Campinas (SP), Brazil.
Jazyk:	angličtina
Zdroj:	Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery [Arq Bras Cir Dig] 2023 Oct 13; Vol. 36, pp. e1768. Date of Electronic Publication: 2023 Oct 13 (Print Publication: 2023).
DOI:	10.1590/0102-672020230050e1768
Abstrakt:	Background: Gastric neuroendocrine tumors are a heterogeneous group of neoplasms that produce bioactive substances. Their treatment varies according to staging and classification, using endoscopic techniques, open surgery, chemotherapy, radiotherapy, and drugs analogous to somatostatin. Aims: To identify and review cases of gastric neuroendocrine neoplasia submitted to surgical treatment. Methods: Review of surgically treated patients from 1983 to 2018. Results: Fifteen patients were included, predominantly female (73.33%), with a mean age of 55.93 years. The most common symptom was epigastric pain (93.3%), and the mean time of symptom onset was 10.07 months. The preoperative upper digestive endoscopy (UDE) indicated a predominance of cases with 0 to 1 lesion (60%), sizing ≥1.5 cm (40%), located in the gastric antrum (53.33%), with ulceration (60%), and Borrmann III (33.33%) classification. The assessment of the surgical specimen indicated a predominance of invasive neuroendocrine tumors (60%), with angiolymphatic invasion in most cases (80%). Immunohistochemistry for chromogranin A was positive in 60% of cases and for synaptophysin in 66.7%, with a predominant Ki-67 index between 0 and 2%. Metastasis was observed in 20% of patients. The surgical procedure most performed was subtotal gastrectomy with Roux-en-Y reconstruction (53.3%). Tumor recurrence occurred in 20% of cases and a new treatment was required in 26.67%. Conclusions: Gastric neuroendocrine tumors have a low incidence in the general population, and surgical treatment is indicated for advanced lesions. The study of its management gains importance in view of the specificities of each case and the need for adequate conduct to prevent recurrences and complications.
Databáze:	MEDLINE
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