Περίληψη:
Purpose Type III gastric neuroendocrine neoplasms (g-NENs) have
historically been regarded as aggressive tumours, hence current
guidelines advocate radical surgery with lymph node dissection. Data on
the roles of endoscopic or less extensive surgical resections are more
limited. The aim of our study is to evaluate the clinicopathological
features and long-term outcomes of patients undergoing endoscopic or
limited surgical resection for localised grade 1 or 2 type III g-NENs
when compared to radical surgery. Methods Retrospective analysis of all
patients diagnosed with a localised grade 1 or 2 type III g-NENs across
six tertiary NEN centers between 2006 and 2019. Results Forty-five
patients were diagnosed with a potentially resectable grade 1 or 2 type
III g-NEN of whom 36 underwent either endoscopic or surgical resection.
No statistically significant differences were found between the three
resection groups in terms of patient age, tumour location, grade or
size. Only tumour size was found to be significantly associated with
poor clinical outcome (p = 0.012) and ROC curve analysis identified
tumour size >10 mm as a negative predictor (AUC:0.8030, p = 0.0021).
Tumours >10 mm were also more likely to be associated with lymph node
metastases on imaging and histology (p = 0.039 and p = 0.026
respectively). Conclusions Localised grade 1 or 2 type III g-NENs had a
good prognosis in this series. Tumour size >10 mm was the most
significant prognostic factor affecting patient outcome. Endoscopic
resection or limited surgical resection is feasible and safe in small
type III g-NENs which demonstrate favourable grade 1/2, well
differentiated histology.
Συγγραφείς:
Exarchou, Klaire
Kamieniarz, Lukasz
Tsoli, Marina
Victor,
Alexandra
Oleinikov, Kira
Khan, Mohid S.
Srirajaskanthan,
Raj
Mandair, Dalvinder
Grozinsky-Glasberg, Simona
Kaltsas,
Gregory
Howes, Nathan
Pritchard, D. Mark
Toumpanakis,
Christos
