Efficacy and safety of endoscopic submucosal dissection for gastrointestinal neuroendocrine tumors: a 10-year data analysis of Northern China

Chen, Xin; Li, Bianxia; Wang, Saiyu; Yang, Bo; Zhu, Lanping; Serrera-Figallo, María-Ángeles; Wu, Jingyi; He, Qijin; Zhao, Jingwen; Zeng, Zheng; Li, Shu; Wang, Tao; Li, Liang

doi:10.1080/00365521.2019.1588367

Cited by 13 publications

(13 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rate of R0 resection was 67–100% in previous reports, although each study contained an extremely small number (3–8) of lesions. 6 , 9 , 11 – 14 , 22 – 24 It is important to note that it is technically difficult, because the wall of the duodenum is thin, which may result in perforation, and the working space is small due to the narrow duodenal lumen. In fact, perforations occurred in most studies on ESD for DNET with an incidence of 25–67%.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection using a ligation device for duodenal neuroendocrine tumors: a simple method

Inokuchi

Hayashi

Kaneta

et al. 2022

Clin Med Insights Gastroenterol

View full text Add to dashboard Cite

Introduction: Duodenal neuroendocrine tumors (DNETs) smaller than 1 cm in diameter, without invasion to the muscularis propria, have a low risk of metastasis. Therefore, DNETs are frequently resected endoscopically. However, among the various procedures, the best fit for DNET in terms of feasibility, effectiveness, and simplicity is unclear. Methods: Patients with DNET who underwent endoscopic submucosal resection using a ligation device (ESMR-L) at Kanagawa Cancer Center between May 2003 and December 2020 were studied retrospectively to evaluate clinical characteristics and short-term and long-term outcomes. Results: Eleven consecutive patients with 12 lesions were treated with 12 sessions of ESMR-L. Lesions were discovered in patients at a median age of 68 (range, 50–83) years. One patient had two lesions at the time of the initial ESMR-L session. Eleven of the 12 lesions (91.7%) existed in the duodenal bulb, of which 10 (83.3%) were in the anterior wall, and the remaining one (8.3%) existed in the descending part of the duodenum. The en bloc and R0 resection rates were 100% and 75%, respectively. The rates of bleeding and perforation were both 0%. Among the four patients who had non-curative resections, two patients underwent additional surgery after ESMR-L. One patient had a local remnant tumor, and the other had lymph node metastasis. In cases of local remnant tumors, the vertical margin was positive in the ESMR-L specimen. In that case, ligation by the O-ring was insufficient, retrospectively. All patients had no recurrence during the median follow-up period of 5.7 years. Discussion: ESMR-L was the best fit for DNET within the indications for endoscopic resection. It is a simple procedure that enables easy and complete resection of DNETs without complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection using a ligation device for duodenal neuroendocrine tumors: a simple method

Inokuchi

Hayashi

Kaneta

et al. 2022

Clin Med Insights Gastroenterol

View full text Add to dashboard Cite

show abstract

“…In their study, parenchyma-sparing resections for G1 and a comprehensive treatment strategy including radical surgical resection with systematic chemotherapy was needed for patients with G2/3 to improve the survival ( 30 ). However, another study showed that the treatment strategies between G2 and G3 in pNETs should not be the same ( 31 ). These patients should receive surgical treatment in patients with limited metastatic disease, if technically feasible.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, targeted therapy with everolimus or sunitinib and somatostatin analogs (octreotide) is also used for advanced pNETs G1/2. Therefore, it is crucial to differentiate between G1/2 and G3 among pNETs than between G1 and G2/3 pNETs ( 31 ). Here, we developed two nomograms, one was used to distinguish G1 and G2/3 and the other was to distinguish G1/2 and G3.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Novel Nomograms Using Serum Tumor Markers for the Prediction of Preoperative Histologic Grades in Gastroenteropancreatic Neuroendocrine Tumors

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

BackgroundTo develop and validate nomogram models for the preoperatively prediction of the histologic grade of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) to provide appropriate treatments.MethodsA total of 1014 participants, including 211 healthy controls, 293 patients with benign diseases, 299 patients with cancers, and 211 patients with GEP-NETs were included in the final analysis. Their sociodemographic and laboratory information, including serum tumor markers such as AFP, CEA, CA19-9, CA72-4, Cyfra21-1 and NSE were collected. Nomogram models were developed to preoperatively predict histologic grades of GEP-NETs.ResultsAmong six serum tumor markers, only NSE was found to have a statistically significant association with the histologic grades in GEP-NETs (G1 vs. G2: p < 0.05; G2 vs. G3: p < 0.001; G1 vs. G3: p < 0.0001), which was combined with sex and age to develop the nomogram models. The first nomogram (to differentiate grade 1(G1) and grade 2/3 tumor (G2/G3)) showed a strong association to differentiate with an AUC of 0.747 (95% CI: 0.663-0.832) and 0.735 (95% CI: 0.624-0.847) in the training and validation datasets, respectively. The second nomogram (to differentiate G1/G2 and G3 tumors) showed a strong association to differentiate with an AUC of 0.827 (95% CI: 0.744-0.911) and 0.847 (95% CI: 0.744-0.950) in the training and validation datasets, respectively. The ROC, area under ROC curve (AUC), calibration curve and decision curve analysis (DCA) demonstrated the clinical usefulness of both models.ConclusionsWe proposed two novel nomogram models based on sex, age and serum NSE levels to preoperatively predict the histologic grades in GEP-NETs to assist the clinical decision-making.

show abstract

“…With the progression of ultrasound endoscopy, endoscopic mucosal resection, and endoscopic submucosal dissection, the advantages of endoscopic resection treatment of gastrointestinal NET tumors have become obvious. The analysis of the endoscopic treatment effect and prognosis of gastrointestinal NET patients by Chen [10] showed that endoscopic submucosal dissection can be used for both en bloc and complete resection of lesions ≤ 3.5 cm, and no new metastasis occurred during the follow-up. Our results showed that after matching, surgical method, age, sex, T stage, and tissue type were not correlated with prognosis, but the degree of differentiation was (P = 0), in line with the ndings reported by Margonis et al [7].…”

Section: Discussionmentioning

confidence: 99%

How to Choose the Best Procedure Type for Duodenal Neuroendocrine Tumors With a Maximum Diameter of 1 to 2 Cm a Propensity Score Matching Analysis Based on the SEER Database

Tang

Xie

Pang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The treatment plan for duodenal neuroendocrine tumors (d-NETs) with a diameter between 1 and 2 cm is still controversy. Aim: To compare the effects of local endoscopic resection and radical resection on the prognosis of d-NETs with a maximum diameter of 1-2 cm. Methods: 286 eligible patients were identified from the SEER database. Propensity score matching (PSM) was done to match patients 1:1 on clinicopathological characteristics. Kaplan-Meier analysis was used to analyze the factors affecting the prognosis.Results: Before PSM, there was no significant difference in the cancer-specific survival (CSS) between the two groups (P = 0.595), but the tumor size, T stage, N stage, and M stage were significantly different between the two groups (all P < 0.05). After 1:1 PSM, the differences in clinicopathological characteristics between the two groups were significantly reduced (all P > 0.05). Survival analysis showed that only the tumor grade was correlated with the prognosis (P = 0); surgical method and other clinicopathological characteristics were not correlated with the prognosis (all P > 0.05). Conclusion: The surgical approach had no significant effect on the prognosis of d-NET patients with a maximum diameter of 1-2 cm and without lymph node metastasis.

show abstract

Efficacy and safety of endoscopic submucosal dissection for gastrointestinal neuroendocrine tumors: a 10-year data analysis of Northern China

Cited by 13 publications

References 27 publications

Endoscopic mucosal resection using a ligation device for duodenal neuroendocrine tumors: a simple method

Endoscopic mucosal resection using a ligation device for duodenal neuroendocrine tumors: a simple method

Development and Validation of Novel Nomograms Using Serum Tumor Markers for the Prediction of Preoperative Histologic Grades in Gastroenteropancreatic Neuroendocrine Tumors

How to Choose the Best Procedure Type for Duodenal Neuroendocrine Tumors With a Maximum Diameter of 1 to 2 Cm a Propensity Score Matching Analysis Based on the SEER Database

Contact Info

Product

Resources

About