Value of ileus-prophylactic surgery for metastatic neuroendocrine midgut tumours

Weber, Frank; Dralle, Henning

doi:10.1016/j.beem.2019.101342

Cited by 4 publications

(2 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 At the time of diagnosis, most patients have metastatic disease. 3 We could not pinpoint the exact etiology of recurrent obstructive events in this patient. NET presenting with bowel obstruction usually result from a mechanical cause.…”

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

Recurrent Gastrointestinal Pseudo-obstruction Because of Well-Differentiated Duodenal Neuroendocrine Tumor

et al. 2022

View full text Add to dashboard Cite

A 56-year-old man presented with recurrent gastrointestinal obstruction. Computed tomography showed fluid-filled, distended stomach, small intestine, and large intestine. Extensive workup including esophagogastroduodenoscopy, colonoscopy, magnetic resonance enterography, push enteroscopy, and video capsule enteroscopy showed no mechanical obstruction. Endoscopic ultrasound-guided biopsy of peripancreatic nodes detected on 18 F-fluorodeoxyglucose positron emission tomography revealed a duodenal neuroendocrine tumor. The lesion showed intense uptake on gallium-68 DOTATOC positron emission tomographycomputed tomography scan. The patient underwent surgical resection of the tumor with resolution of bowel obstruction events. He had elevated pancreatic polypeptide levels, which are known to delay gastric emptying and could explain his symptoms.Previous computed tomography (CT) scans of the abdomen showed variable distension of the stomach, or fluid-filled small intestine with concern for transition point at the ileum, or distended large intestine. He had formerly undergone 2 esophagogastroduodenoscopies, which did not reveal gastric outlet obstruction. His current CT abdomen showed a fluid-filled stomach and duodenum, suggestive of gastric outlet obstruction (Figure 1). Magnetic resonance enterography (MRE) did not show obstruction, but demonstrated a 2.1 3 2.3-cm right mesenteric nodule with similar enhancement as the spleen, raising the possibility of ectopic splenic tissue, and a 0.7-cm nodule posterior to the uncinate process.Push enteroscopy revealed esophagitis and severe aphthous ulcerations in the small intestine, but no obstruction. Colonoscopy did not reveal any obstructive pathology. Video capsule enterography revealed erythematous mucosa with villous blunting and nonobstructive luminal narrowing in the duodenum through which the capsule passed easily.An 18 F-fluorodeoxyglucose positron emission tomography ( 18 FDG PET)/CT scan was performed to further evaluate the mesenteric lesion seen on MRE. It showed multiple mild to moderately FDG avid cervical lymph nodes (LN), the largest a 4-cm left supraclavicular LN. It redemonstrated the soft-tissue lesion anterior to the duodenum with mild to moderate FDG uptake and multiple

show abstract

Section: Discussionmentioning

confidence: 83%

“…10 Hence, these tumors can be associated with a mesenteric desmoplastic reaction, resulting in GI obstruction. 3,11 A mesenteric inflammatory reaction that, if allowed to persist, might have progressed to a desmoplasia could also cause recurrent obstructions in this patient. However, no fibrosis was appreciated on exploratory laparotomy.…”

Section: Discussionmentioning

confidence: 87%

Recurrent Gastrointestinal Pseudo-obstruction Because of Well-Differentiated Duodenal Neuroendocrine Tumor

et al. 2022

View full text Add to dashboard Cite

show abstract

Combined medical therapy, nuclear medicine therapy and other therapies in metastatic neuroendocrine tumor

Nagel

Herrmann

Lahner

et al. 2022

Nuclear Medicine and Molecular Imaging

View full text Add to dashboard Cite

Effect of primary tumour resection without curative intent in patients with metastatic neuroendocrine tumours of the small intestine and right colon: meta-analysis

Heede

Chidambaram

Slycke

et al. 2021

BJS

View full text Add to dashboard Cite

Background Patients with small intestinal neuroendocrine tumours (siNETs) usually present with advanced disease. Primary tumour resection without curative intent is controversial in patients with metastatic siNETs. The aim of this meta-analysis was to investigate survival after primary tumour resection without curative intent compared with no resection in patients with metastatic siNETs. Methods A systematic literature search was performed, using MEDLINE® (PubMed), Embase®, Web of Science, and the Cochrane Library up to 25 February 2021. Studies were included if survival after primary tumour resection versus no resection in patients with metastatic siNETs was reported. Results were pooled in a random-effects meta-analysis, and are reported as hazard ratios (HRs) with 95 per cent confidence intervals. Sensitivity analyses were undertaken to enable comment on the impact of important confounders. Results After screening 3659 abstracts, 16 studies, published between 1992 and 2021, met the inclusion criteria, with a total of 9428 patients. Thirteen studies reported HRs adjusted for important confounders and were included in the meta-analysis. Median overall survival was 112 (i.q.r. 82–134) months in the primary tumour resection group compared with 60 (74–88) months in the group without resection. Five-year overall survival rates were 74 (i.q.r. 67–77) and 44 (34–45) per cent respectively. Primary tumour resection was associated with improved survival compared with no resection (HR 0.55, 95 per cent c.i. 0.47 to 0.66). This effect remained in sensitivity analyses. Conclusion Primary tumour resection is associated with increased survival in patients with advanced, metastatic siNETs, even after adjusting for important confounders.

show abstract

Value of ileus-prophylactic surgery for metastatic neuroendocrine midgut tumours

Cited by 4 publications

References 42 publications

Recurrent Gastrointestinal Pseudo-obstruction Because of Well-Differentiated Duodenal Neuroendocrine Tumor

Recurrent Gastrointestinal Pseudo-obstruction Because of Well-Differentiated Duodenal Neuroendocrine Tumor

Combined medical therapy, nuclear medicine therapy and other therapies in metastatic neuroendocrine tumor

Effect of primary tumour resection without curative intent in patients with metastatic neuroendocrine tumours of the small intestine and right colon: meta-analysis

Contact Info

Product

Resources

About