Background: Resection is the main method for treating gastric neuroendocrine neoplasms (g-NENs). However, the threshold for tumor size needs to be removed, and the prognostic difference between the endoscopic and surgical resection groups remains unclear.
Methods: In this study, 929 g-NENs patients without distant metastasis were collected and analyzed (857 patients from the SEER database, 72 patients from Wuhan Union Hospital or the First Affiliated Hospital of Shihezi University).
Results: Overall, for g-NENs without distant metastasis, the resected group had a better prognosis than the unresected group ( p =0.0019). For tumor >2cm, the resection group had a better prognosis than the unresected group ( p =0.0002), but there was no significant difference in survival between the endoscopic and surgical resection group ( p >0.05). For tumor <1cm or 1-2cm, there was no significant difference in survival between the resected group and the unresected group, and there was no significant difference in survival between the endoscopic resection group and the surgical resection group ( p >0.05). Furthermore, for g-NENs confined to in-situ and T1, or with well-differentiated morphology or w/wo lymph node metastasis without distant metastasis, there was no significant difference in prognosis between the endoscopic resection group and the surgical resection group ( p >0.05).
Conclusions: Resection can significantly improve the prognosis of g-NENs patients without distant metastasis, and 2cm can be used as a resection threshold. For g-NENs within the size of endoscopic resection, which localized in situ and T1, or with well-differentiated morphology, or w/wo lymph node metastasis without distant metastasis, endoscopic resection is feasible.