Clinicopathological features and outcome of type 3 gastric neuroendocrine tumours

Min, Byung Hoon; Hong, Min Eui; Lee, J. H.; Rhee, Poong–Lyul; Sohn, Tae Sung; Kim, S.; Kim, K.-M.; Kim, J. J.

doi:10.1002/bjs.10901

Cited by 44 publications

(44 citation statements)

References 24 publications

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“…Eight of the studies included 121 selected patients who underwent endoscopic resection (EMR or ESD) for small localised tumours. Complete resection rates varied between 72% and 80% in most of the series, but was 87% in the largest series 31‐33 . There was insufficient information to determine whether complete resection was more likely following ESD than EMR and ESD was only reported in 44 patients.…”

Section: Resultsmentioning

confidence: 93%

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

Exarchou

Howes

Pritchard

2020

Aliment Pharmacol Ther

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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.

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Section: Resultsmentioning

confidence: 93%

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

Exarchou

Howes

Pritchard

2020

Aliment Pharmacol Ther

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“…Similar to type I G-NETs, excess gastrin causes hypertrophy and hyperplasia of the ECFs. In these cases, it is also common for lesions to be small and multiple[ 2 , 18 , 33 - 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…The production of gastrin and HCl is within normal values, except in rare cases where the tumor itself can produce gastrin[ 36 ]. They are generally characterized by being single lesions, larger than 1 cm in size and with greater likelihood of evolving to regional and systemic metastases[ 2 , 20 , 33 , 34 ]. More than half of patients with type III G-NET are metastatic at diagnosis, mainly to the liver.…”

Section: Discussionmentioning

confidence: 99%

“…Type III lesions are also investigated by upper endoscopy with biopsy, which shows a single lesion with normal mucosa. The pH is < 4, which is normal for the gastric pattern[ 2 , 18 , 20 , 33 , 34 ]. In addition to the neoplastic lesion, the adjacent normal mucosa should also be biopsied in order to assess whether there is atrophic gastritis, intestinal metaplasia and ECF hyperplasia, which are not usually present[ 2 , 18 , 19 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

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Gastric neuroendocrine tumor: A practical literature review

Roberto

Rodrigues

Peixoto

et al. 2020

WJGO

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Gastric neuroendocrine tumors are gastric neoplasms originating from enterochromaffin type cells and are inserted in a larger group, named gastroenteropancreatic neuroendocrine tumors. They are considered rare and variable in terms of their clinical, morphological and functional characteristics and may be indolent or aggressive. They are classified into types I, II and III, according to their pathophysiology, behavior and treatment. Their diagnosis occurs, in most cases, incidentally during upper digestive endoscopies, presenting as simple gastric polyps. Most cases (type I and type II) are related to hypergastrinemia, can be multiple and are treated by endoscopic resection, whenever possible. The use of somatostatin analogs for tumor control may be one of the options for therapy, in addition to total or subtotal gastrectomy for selected cases. Adjuvant chemotherapy is only reserved for poorly differentiated neuroendocrine carcinomas. Although rare, gastric neuroendocrine tumors have an increasing incidence over the years, therefore deserving more comprehensive studies on its adequate treatment. The present study reviews and updates management recommendations for gastric neuroendocrine tumors.

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“…Type III gastric NET are found in the setting of normal gastrin levels and exhibit a more aggressive behavior; they are treated surgically in a manner similar to adenocarcinoma: formal gastric resection and regional lymphadenectomy. Small, low-grade, Type III gastric NET without evidence of lymphovascular invasion can be treated with wedge or endoscopic resection [ 148 ].…”

Section: Gastric Malignanciesmentioning

confidence: 99%

Epidemiology, Diagnosis, Staging and Multimodal Therapy of Esophageal and Gastric Tumors

Cummings

Wong

Palm

et al. 2021

Cancers

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Gastric and esophageal tumors are diverse neoplasms that involve mucosal and submucosal tissue layers and include squamous cell carcinomas, adenocarcinomas, spindle cell neoplasms, neuroendocrine tumors, marginal B cell lymphomas, along with less common tumors. The worldwide burden of esophageal and gastric malignancies is significant, with esophageal and gastric cancer representing the ninth and fifth most common cancers, respectively. The approach to diagnosis and staging of these lesions is multimodal and includes a combination of gastrointestinal endoscopy, endoscopic ultrasound, and cross-sectional imaging. Likewise, therapy is multidisciplinary and combines therapeutic endoscopy, surgery, radiotherapy, and systemic chemotherapeutic tools. Future directions for diagnosis of esophageal and gastric malignancies are evolving rapidly and will involve advances in endoscopic and endosonographic techniques including tethered capsules, optical coherence tomography, along with targeted cytologic and serological analyses.

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Clinicopathological features and outcome of type 3 gastric neuroendocrine tumours

Abstract: Low-grade type 3 gastric NET has non-aggressive features and a favourable prognosis. Wedge or endoscopic resection may be a valid option for patients with type 3 gastric G1 NET no larger than 1·5 cm without lymphovascular invasion.

Cited by 44 publications

References 24 publications

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

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

Gastric neuroendocrine tumor: A practical literature review

Epidemiology, Diagnosis, Staging and Multimodal Therapy of Esophageal and Gastric Tumors

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