Is local excision sufficient in selected grade 1 or 2 type III gastric neuroendocrine neoplasms?
Autor: | Dalvinder Mandair, Simona Grozinsky-Glasberg, Raj Srirajaskanthan, Alexandra Victor, Lukasz Kamieniarz, Christos Toumpanakis, Kira Oleinikov, Gregory Kaltsas, D. Mark Pritchard, Klaire Exarchou, Marina Tsoli, Nathan Howes, Mohid S. Khan |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Local excision Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism 03 medical and health sciences 0302 clinical medicine Endocrinology Stomach Neoplasms medicine Humans Radical surgery Lymph node Retrospective Studies medicine.diagnostic_test business.industry Curve analysis Histology Prognosis Endoscopy Neuroendocrine Tumors Dissection medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Radiology Good prognosis business |
Zdroj: | ENDOCRINE |
ISSN: | 1559-0100 1355-008X |
Popis: | Type III gastric neuroendocrine neoplasms (g-NENs) have historically been regarded as aggressive tumours, hence current guidelines advocate radical surgery with lymph node dissection. Data on the roles of endoscopic or less extensive surgical resections are more limited. The aim of our study is to evaluate the clinicopathological features and long-term outcomes of patients undergoing endoscopic or limited surgical resection for localised grade 1 or 2 type III g-NENs when compared to radical surgery. Retrospective analysis of all patients diagnosed with a localised grade 1 or 2 type III g-NENs across six tertiary NEN centers between 2006 and 2019. Forty-five patients were diagnosed with a potentially resectable grade 1 or 2 type III g-NEN of whom 36 underwent either endoscopic or surgical resection. No statistically significant differences were found between the three resection groups in terms of patient age, tumour location, grade or size. Only tumour size was found to be significantly associated with poor clinical outcome (p = 0.012) and ROC curve analysis identified tumour size >10 mm as a negative predictor (AUC:0.8030, p = 0.0021). Tumours >10 mm were also more likely to be associated with lymph node metastases on imaging and histology (p = 0.039 and p = 0.026 respectively). Localised grade 1 or 2 type III g-NENs had a good prognosis in this series. Tumour size >10 mm was the most significant prognostic factor affecting patient outcome. Endoscopic resection or limited surgical resection is feasible and safe in small type III g-NENs which demonstrate favourable grade 1/2, well differentiated histology. |
Databáze: | OpenAIRE |
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