EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1

Asselt, Sophie J. van; Brouwers, Adrienne H.; Dullemen, Hendrik M. van; Jagt, Eric J. van der; Bongaerts, Alphons H.H.; Kema, Ido P.; Koopmans, Klaas Pieter; Valk, Gerlof D.; Timmers, Henri J L M; Herder, Wouter W. de; Feelders, Richard A; Fockens, Paul; Sluiter, Wim J.; Vries, Elisabeth G.E. de; Links, Thera P.

doi:10.1016/j.gie.2014.09.037

Cited by 71 publications

(56 citation statements)

References 33 publications

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“…We therefore stress the importance of a strict radiological follow-up for these lesions especially in patients managed conservatively. In this setting, EUS should be recommended for patients with usually long follow-up periods, due to its higher sensitivity and the lack of ionizing radiation [23]. The other advantage of EUS is to perform FNA for excluding from an active surveillance protocol those patients with higher-grade tumors.…”

Section: Discussionmentioning

confidence: 99%

Active Surveillance versus Surgery of Nonfunctioning Pancreatic Neuroendocrine Neoplasms ≤2 cm in MEN1 Patients

Partelli¹,

Tamburrino²,

Lopez

et al. 2016

Neuroendocrinology

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Background: The aim of this study was to evaluate the efficacy of conservative treatment for nonfunctioning pancreatic neuroendocrine neoplasms (NF-PNEN) ≤2 cm in multiple endocrine neoplasia type 1 (MEN1)-affected patients compared with surgical treatment. Methods: The databases of 4 tertiary referral institutions (San Raffaele Scientific Institute, Milan; Philipps-Universität Marburg, Marburg; University of Padua, Padua; Royal Free Hospital, London) were analyzed. A comparison of conservative management and surgery at initial diagnosis of NF-PNEN ≤2 cm between 1997 and 2013 was performed. Results: Overall, 27 patients (45%) underwent up-front surgery and 33 patients (55%) were followed up after the initial diagnosis. A higher proportion of patients in the surgery group were female (70 vs. 33%, p = 0.004). Patients were mainly operated on in the period 1997-2007 as compared with the period 2008-2013 (n = 17; 63 vs. 37%; p = 0.040). The rate of multifocal tumors was higher in the surgery group (n = 24; 89%) than in the ‘no surgery' group (n = 22; 67%; p = 0.043). After a median follow-up of 126 months, 1 patient deceased due to postoperative complications within 30 days after surgery. The 5-, 10-, and 15-year progression-free survival (PFS) rates were 63, 39, and 10%, respectively. The median PFS was similar in the two groups. Overall, 13 patients (32.5%) were operated on after initial surgical or conservative treatment. The majority of the surgically treated patients had stage 1 (77.5%), T1 (77.5%), and G1 (85%) tumors. Conclusions: NF-PNEN ≤2 cm in MEN1 patients are indolent neoplasms posing a low oncological risk. Surgical treatment of these tumors at initial diagnosis is rarely justified in favor of conservative treatment.

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Section: Discussionmentioning

confidence: 99%

Active Surveillance versus Surgery of Nonfunctioning Pancreatic Neuroendocrine Neoplasms ≤2 cm in MEN1 Patients

Partelli¹,

Tamburrino²,

Lopez

et al. 2016

Neuroendocrinology

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“…With the optimization of the materials and techniques, EUS is progressively assuming the prominent position as first choice imaging procedure for the assessment of the pancreas in MEN-1 patients, being superior to CT, MRI, and somatostatin receptor scintigraphy [21, 22]. In such patient population, somatostatin receptor scintigraphy is considered being the most reliable method for the detection of metastatic disease [4].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound Features of Multiple Endocrine Neoplasia Type 1-Related versus Sporadic Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Study

Tamagno

Scherer

Caimo³

et al. 2018

Digestion

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Aim: Pancreatic neuroendocrine tumors (pNETs) can occur in patients with a familial syndrome either as multiple endocrine neoplasia type 1 (MEN-1) or as sporadic tumors. Endoscopic ultrasound (EUS) has become one of the first-line investigations for pNET characterization. The ultrasonographic features of pNETs may differ depending on the familial versus sporadic pathogenesis of the tumor. Therefore, the EUS findings could help and direct the definition of a pNET with an impact on the most appropriate diagnostic and therapeutic patient management. Methods: In this single-center retrospective study, we reviewed the EUS features of 94 pNETs from 37 MEN-1 patients and 15 pNETs from 11 sporadic disease patients at the time of their first EUS assessment. We analyzed the most relevant morphological and ultrasonographic characteristics of the tumors and compared the findings between the 2 patient groups. Results: Patients with MEN-1 more likely present with multiple pNETs than patients with sporadic disease. Sporadic pNETs are usually much bigger than those due to MEN-1. Moreover, pNETs are more heterogeneous in patients with sporadic disease than in those with MEN-1. No statistical difference with regard to definition of the margins, morphology, and vascularization of the pNETs appears between the 2 groups. Conclusions: Patients with sporadic disease usually present with bigger and more heterogeneous pNETs than patients with MEN-1, who tend to present with a higher number of lesions. EUS can facilitate the precise characterization of a pNET, and the ultrasonographic features of the lesion can help and distinguish MEN-1-related versus sporadic disease.

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“…It was developed as somatostatin receptor scintigraphy with 111 In-pentetreotide (SRS) in the 1990s and presented the standard imaging for GEP-NENs for more than two decades in most countries. The technique is based on the fact that GEP-NENs express somatostatin receptors (Shi et al 1998, van Essen et al 2013, especially the subtypes sst2 and sst5, which allow to visualize these tumors with radiolabeled somatostatin analogs. Several studies in the past have shown that the SRS scintigraphy is a useful imaging modality to detect pNEN and is even more sensitive than cross-sectional imaging (Gibril et al 1996, Langer et al 2004, Sundin 2012, van Essen et al 2013.…”

Section: :10mentioning

confidence: 99%

“…Compared to the general Dutch population, the breast cancer was diagnosed about 12 years earlier (Dreijerink et al 2014). The same group performed a cross-sectional case-control study using the Dutch MEN1 cohort (van Leeuwaarde et al 2017). In 138 MEN1 female patients, a questionnaire regarding breast cancer was carried out.…”

Section: Breast Cancermentioning

confidence: 99%

The future: diagnostic and imaging advances in MEN1 therapeutic approaches and management strategies

Manoharan¹,

Albers²,

Bartsch³

2017

Endocrine-Related Cancer

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Prospective randomized data are lacking, but current clinical expert guidelines recommend annual screening examinations, including laboratory assessments and various imaging modalities (e.g. CT, MRI, scintigraphy and EUS) for patients with multiple endocrine neoplasia type 1 (MEN1). Routine screening is proposed to detect and localize neuroendocrine manifestations as early as possible. The goal is timely intervention to improve quality of life and to increase life expectancy by preventing the development of life-threatening hormonal syndromes and/or metastatic disease. In recent years, some studies compared different and new imaging methods regarding their sensitivity and utility in MEN1 patients. This present article reviews the proposed diagnostic tools for MEN1 screening as well as potential future perspectives.

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EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1

Abstract: NTR1668.).

Cited by 71 publications

References 33 publications

Active Surveillance versus Surgery of Nonfunctioning Pancreatic Neuroendocrine Neoplasms ≤2 cm in MEN1 Patients

Active Surveillance versus Surgery of Nonfunctioning Pancreatic Neuroendocrine Neoplasms ≤2 cm in MEN1 Patients

Endoscopic Ultrasound Features of Multiple Endocrine Neoplasia Type 1-Related versus Sporadic Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Study

The future: diagnostic and imaging advances in MEN1 therapeutic approaches and management strategies

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