Systematic review: management of localised low-grade upper gastrointestinal neuroendocrine tumours

Autor:	David M. Pritchard, Klaire Exarchou, Nathan Howes
Rok vydání:	2020
Předmět:	medicine.medical_specialty Endoscopy Gastrointestinal 03 medical and health sciences Upper Gastrointestinal Tract 0302 clinical medicine Medicine Upper gastrointestinal Humans Pharmacology (medical) 030212 general & internal medicine Gastrointestinal Neoplasms Retrospective Studies Neoplasm Grading Hepatology medicine.diagnostic_test business.industry Stomach Incidence (epidemiology) Gastroenterology Retrospective cohort study Prognosis Optimal management Endoscopy Neuroendocrine Tumors medicine.anatomical_structure Duodenum 030211 gastroenterology & hepatology Radiology business
Zdroj:	ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN:	1365-2036
Popis:	Background Neuroendocrine tumours (NETs) of the stomach and duodenum are rare, but are increasing in incidence. Optimal management of localised, low-grade gastric and duodenal NETs remains controversial. Aims To systematically review recent literature that has evaluated the management of localised low-grade gastric and duodenal NETs. Methods A systematic literature search was conducted. Articles were screened and eligible articles fully assessed. Additional articles were identified through the included articles' reference lists. Results Several relevant retrospective case series were identified, but there was considerable heterogeneity between studies and they reported a variety of parameters. Type I gastric NETs had an excellent prognosis and conservative management approaches such as endoscopic surveillance/resection were appropriate in most cases. Many type III gastric NETs were low grade and appeared to have a better prognosis than has previously been appreciated. Endoscopic rather than surgical resection was therefore effective in some patients who had small, low-grade tumours. Duodenal NETs were more heterogenous. Endoscopic resection was generally safe and effective in patients who had small, low-grade, nonfunctional, non-ampullary tumours. However, some patients, especially those with larger or ampullary duodenal NETs, required surgical resection. Conclusions Most type I gastric NETs behave indolently and surgical resection is only rarely indicated. Some type III gastric and duodenal NETs have a worse prognosis, but selected patients who have small, localised, nonfunctional, low-grade tumours are adequately and safely treated by endoscopic resection. Due to the complexity of this area, a multidisciplinary approach to management is strongly recommended.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::53c97b222e1f42e296020a413e59748f https://pubmed.ncbi.nlm.nih.gov/32390152 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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