The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter
| Autor: | Tomoyuki Koike, Tooru Shimosegawa, Kiyotaka Asanuma, Hironobu Sasano, Yoshifumi Inomata, Hiroaki Musha, Atsuko Kasajima, Hiroyuki Endo, Toru Horii, Naoki Asano, Motoki Ohyauchi, Tomohiro Nakamura, Atsushi Ikehata, Toshikazu Sano, Naoki Nakaya, Fumiyoshi Fujishima, Waku Hatta, Katsunori Iijima, Satoshi Yokosawa |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
Male medicine.medical_specialty Endoscopic Mucosal Resection Duodenum Kaplan-Meier Estimate Neuroendocrine tumors Metastasis Neoplasms Multiple Primary 03 medical and health sciences 0302 clinical medicine Duodenal Neoplasms Risk Factors Internal medicine medicine Humans Intestinal Mucosa Duodenoscopy Aged Retrospective Studies business.industry Gastroenterology Middle Aged medicine.disease Tumor Burden Survival Rate Neuroendocrine Tumors 030220 oncology & carcinogenesis Lymphatic Metastasis Treatment strategy 030211 gastroenterology & hepatology Female business Follow-Up Studies |
| Zdroj: | Digestion. 95(3) |
| ISSN: | 1421-9867 |
| Popis: | Background/Aims: The treatment strategy for non-ampullary duodenal neuroendocrine tumors (NAD-NETs) ≤20 mm in diameter has not been established. In this study, we aimed to evaluate the detailed characteristics of NAD-NETs ≤20 mm in diameter to clarify the risk factors of subsequent metastasis. Methods: The patients with NAD-NETs ≤20 mm in diameter who had been treated at 12 institutions between 1992 and 2013 were enrolled. Clinical records were retrieved, and histopathological findings of all cases were centrally reviewed by 2 pathologists. Results: We studied 49 patients with a mean follow-up period of 66.5 months. Thirty-five patients were initially treated with endoscopic resection (ER), and 14 with surgery. A univariate analysis revealed the ORs and 95% CIs of the risk factors for metastasis were lymphovascular invasion (12.5 [2.01-77.9]), multiple tumors (9.75 [1.46-65.4]), a tumor size of 11-20 mm (6.67 [1.21-36.6]), and World Health Organization grade G2 (7.13 [1.16-43.9]). Five-year overall and disease-specific survival rates were 86.1 and 97.2%, respectively. Conclusion: This is the first study to demonstrate the risk factors of metastasis in NAD-NETs ≤20 mm in diameter. These findings may be helpful for determining the appropriate therapeutic approach and the clinical strategy of treatment following ER. |
| Databáze: | OpenAIRE |
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