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Long-term outcome of endoscopic and surgical resection for foregut neuroendocrine tumors.
J Dig Dis 2015; 16(10):595-600JD

Abstract

OBJECTIVE

Endoscopic resection (ER) of foregut neuroendocrine tumors (NETs) is increasingly performed instead of surgery. This study aimed to compare the long-term therapeutic outcomes of ER and surgical resection (SR) for foregut NETs.

METHODS

From 2002 to 2012, a total of 49 patients with histologically confirmed foregut NETs were treated by ER (n = 33) and SR (n = 16). The clinicopathological characteristics and therapeutic outcomes were evaluated.

RESULTS

Of the 33 patients who underwent ER [endoscopic mucosal resection (n = 26), endoscopic mucosal dissection (n = 7)], 32 were diagnosed as NET-G1 and NET-G2, and the other as neuroendocrine carcinoma (NEC). Of the 16 patients who underwent SR, 10 were diagnosed as NET-G1, 2 as NET-G2 and 4 as NEC. The median tumor size was significantly smaller in the ER group compared with the SR group (7 mm vs 19 mm, P = 0.001). In almost all patients treated with ER (32/33), NET invasion was limited to the mucosa and submucosa. Non-curative resections were observed in 24.2% of the patients in the ER group (8/33) and 25.0% in the SR group (4/16). No recurrence occurred in NET cases with positive resection margins by ER. However, all cases of non-curative resection with lymphatic invasion (one in the ER group and four in the SR group) developed liver metastasis during the follow-up despite complete resection, and all these five patients has histologically confirmed NECs.

CONCLUSION

NET patients treated by ER may have a good prognosis if the tumor size is small and histologically low grade without lymphatic invasion.

Authors+Show Affiliations

Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine.Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine.Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine.Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine.Department of Surgery, Soonchunhyang University College of Medicine.Department of Surgery, Soonchunhyang University College of Medicine.Department of Pathology, Soonchunhyang University College of Medicine, Bucheon, Korea.Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine.Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26315879

Citation

Jung, Hee Jae, et al. "Long-term Outcome of Endoscopic and Surgical Resection for Foregut Neuroendocrine Tumors." Journal of Digestive Diseases, vol. 16, no. 10, 2015, pp. 595-600.
Jung HJ, Hong SJ, Han JP, et al. Long-term outcome of endoscopic and surgical resection for foregut neuroendocrine tumors. J Dig Dis. 2015;16(10):595-600.
Jung, H. J., Hong, S. J., Han, J. P., Kim, H. S., Jeong, G. A., Cho, G. S., ... Lee, M. S. (2015). Long-term outcome of endoscopic and surgical resection for foregut neuroendocrine tumors. Journal of Digestive Diseases, 16(10), pp. 595-600. doi:10.1111/1751-2980.12279.
Jung HJ, et al. Long-term Outcome of Endoscopic and Surgical Resection for Foregut Neuroendocrine Tumors. J Dig Dis. 2015;16(10):595-600. PubMed PMID: 26315879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome of endoscopic and surgical resection for foregut neuroendocrine tumors. AU - Jung,Hee Jae, AU - Hong,Su Jin, AU - Han,Jae Pil, AU - Kim,Hyun Su, AU - Jeong,Gui-Ae, AU - Cho,Gyu-Seok, AU - Kim,Hee Kyoung, AU - Ko,Bong Min, AU - Lee,Moon Sung, PY - 2015/03/19/received PY - 2015/07/02/revised PY - 2015/08/03/accepted PY - 2015/8/29/entrez PY - 2015/9/1/pubmed PY - 2016/10/19/medline KW - endoscopic resection KW - foregut KW - long-term outcome KW - neoplasm metastasis KW - neuroendocrine tumors KW - surgery SP - 595 EP - 600 JF - Journal of digestive diseases JO - J Dig Dis VL - 16 IS - 10 N2 - OBJECTIVE: Endoscopic resection (ER) of foregut neuroendocrine tumors (NETs) is increasingly performed instead of surgery. This study aimed to compare the long-term therapeutic outcomes of ER and surgical resection (SR) for foregut NETs. METHODS: From 2002 to 2012, a total of 49 patients with histologically confirmed foregut NETs were treated by ER (n = 33) and SR (n = 16). The clinicopathological characteristics and therapeutic outcomes were evaluated. RESULTS: Of the 33 patients who underwent ER [endoscopic mucosal resection (n = 26), endoscopic mucosal dissection (n = 7)], 32 were diagnosed as NET-G1 and NET-G2, and the other as neuroendocrine carcinoma (NEC). Of the 16 patients who underwent SR, 10 were diagnosed as NET-G1, 2 as NET-G2 and 4 as NEC. The median tumor size was significantly smaller in the ER group compared with the SR group (7 mm vs 19 mm, P = 0.001). In almost all patients treated with ER (32/33), NET invasion was limited to the mucosa and submucosa. Non-curative resections were observed in 24.2% of the patients in the ER group (8/33) and 25.0% in the SR group (4/16). No recurrence occurred in NET cases with positive resection margins by ER. However, all cases of non-curative resection with lymphatic invasion (one in the ER group and four in the SR group) developed liver metastasis during the follow-up despite complete resection, and all these five patients has histologically confirmed NECs. CONCLUSION: NET patients treated by ER may have a good prognosis if the tumor size is small and histologically low grade without lymphatic invasion. SN - 1751-2980 UR - https://www.unboundmedicine.com/medline/citation/26315879/Long_term_outcome_of_endoscopic_and_surgical_resection_for_foregut_neuroendocrine_tumors_ L2 - https://doi.org/10.1111/1751-2980.12279 DB - PRIME DP - Unbound Medicine ER -