Dataset Information

Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10 mm in diameter.

ABSTRACT:

Purpose

Type I gastric neuroendocrine neoplasms (g-NENs) have a low risk of metastasis and a generally favourable prognosis. Patients with small type I g-NENs (≤10 mm) frequently require no treatment, whereas those with larger polyps usually undergo resection. We evaluated the safety and outcomes of endoscopic surveillance after no initial treatment in selected patients with type I g-NENs.

Methods

Retrospective analysis of type I g-NEN patients across two European Neuroendocrine Tumour Society Centers of Excellence 2003-2019.

Results

Following initial assessment, 87 of 115 patients with type I g-NEN (75 with polyps ≤10 mm) received no initial treatment and underwent endoscopic surveillance. 79/87 (91%) demonstrated no clinically meaningful change in tumour size or grade over a median 62 month follow up. Only two patients developed NEN progression that required a change in management and two other patients developed gastric adenocarcinoma/high grade dysplasia; all four initially had ≥11 mm g-NENs.

Conclusions

Patients with ≤10 mm type I g-NENs were unlikely to develop clinically significant tumour progression and in most cases, resection was not needed. The endoscopic surveillance interval could therefore potentially be safely increased to every 2-3 years in such patients. However, lifelong surveillance is still advocated due to the additional risk of developing gastric adenocarcinoma.

SUBMITTER: Exarchou K

PROVIDER: S-EPMC9474380 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10 mm in diameter.

Exarchou Klaire K Hu Haiyi H Stephens Nathan A NA Moore Andrew R AR Kelly Mark M Lamarca Angela A Mansoor Wasat W Hubner Richard R McNamara Mairéad G MG Smart Howard H Howes Nathan R NR Valle Juan W JW Pritchard D Mark DM

Endocrine 20220727 1

<h4>Purpose</h4>Type I gastric neuroendocrine neoplasms (g-NENs) have a low risk of metastasis and a generally favourable prognosis. Patients with small type I g-NENs (≤10 mm) frequently require no treatment, whereas those with larger polyps usually undergo resection. We evaluated the safety and outcomes of endoscopic surveillance after no initial treatment in selected patients with type I g-NENs.<h4>Methods</h4>Retrospective analysis of type I g-NEN patients across two European Neuroendocrine T ...[more]

PMID: 35895180

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Project description:ObjectiveTo explore the risk factors for perforation during endoscopic submucosal excavation (ESE) for gastric muscularis propria tumours less than 10 mm in diameter. This study provides clinical guidance for preventing the occurrence of intraoperative adverse events.MethodsSamples of gastric muscularis propria tumours less than 10 mm in diameter were removed via ESE at Shenzhen Second People's Hospital and were collected from June 2023 to August 2024. The general clinical characteristics of the patients, location, size, growth pattern, and pathology of the tumours, operation time, resection time, perforation incidence and bleeding incidence were analysed, and logistic regression was used to calculate the risk factors for perforation and bleeding.ResultsA total of 102 patients were included in this study. The tumours were successfully removed from all patients. The mean age was 52.28 ± 11.84 years. There were 34 (33.33%) males. The mean size was 6.96 ± 1.82 mm. 89 (87.25%) tumours exhibited an intraluminal growth pattern. In total, 79 (77.45%) tumours were in the gastric body, and 23 (22.55%) tumours were in the gastric fundus. The mean operation time was 35.26 ± 23.15 min, and the mean resection time was 27.88 ± 21.77 min. A total of 55 (53.92%) tumours were leiomyoma, and 43 (42.16%) tumours were GIST. There were 4 (3.92%) tumours classified as other lesions. 41 (40.20%) patients experienced intraoperative bleeding, all of which had minor bleeding and successful haemostasis under endoscopy.There were 27 (26.47%) concurrent perforation, of which,24(88.89%) were diagnosed as GIST, and 3(11.11%) were diagnosed as leiomyoma. All perforations were successfully managed with an endoscopic suture. According to the multivariate regression analysis, a pathologic diagnosis was a risk factor for perforation. When the pathological diagnosis is GIST, the risk of perforation increases (PE = 18.632, 95% CI 4.571 ~ 75.941; p < 0.001). Gender,age,tumor size, growth pattern, location, and resection time were not found to be risk factors for perforation.all of observed factors were not the risk factors for bleeding.ConclusionESE is an effective removal method for gastric muscularis propria tumours less than 10 mm in diameter.Intraoperative bleeding and perforation are common.However, these complications are controllable.GIST is an independent risk factor for the perforation.When the tumour is diagnosed as a GIST, the incidence of perforation is significantly increased.

Dataset Information

Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10 mm in diameter.

Purpose

Methods

Results

Conclusions

Publications

Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10 mm in diameter.

Similar Datasets

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