Abstract
Background
This study aimed to evaluate the outcome of patients with type 1 gastric neuroendocrine
neoplasia (T1gNENs) treated with different endoscopic approaches.
Methods
Patients were managed with endoscopic surveillance at regular intervals. Resection
was performed by forceps or cold snare in tumours < 10 mm, otherwise mucosal resection
(EMR) or submucosal dissection (ESD) were done.
Results
127 T1gNENs, detected in 80 patients, were included. 87.4% of them were <5 mm, whereas
8.7% were 6–10 mm, 3.1% were 11–20 mm, and 0.8% was >20 mm. Ki67 <3%% was found in
85.8% tumours, whereas it was 3%-20% in the remaining 14.2% lesions. Noninterventional
management (surveillance without radical resection) was performed in 15 patients (18.7%)
with T1gNENs <5 mm. None of them underwent disease progression during follow-up. among
the 65 patients treated by radical endoscopic resection, 37 patients (56.9%) had disease
recurrence. 48.5% T1gNENs were removed by forceps, 16.8% by cold snare, 31.7% by EMR
and 3% by ESD. The recurrence rate was similar among the different endoscopic techniques
used.
Conclusions
The management of T1gNENs may be planned based on tumour size. T1gNENs < 5 mm for
which the initial removal is not radical could be followed up by noninterventional
endoscopic surveillance.
Keywords
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References
- Gastric neuroendocrine tumor: a practical literature review.World J Gastrointest Oncol. 2020; 12: 850-856
- Current concepts on gastric carcinoid tumors.Gastroenterol Res Pract. 2012; 2012287825
- Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States.JAMA Oncol. 2017; 3: 1335-1342
- Update on gastroenteropancreatic neuroendocrine tumors.Dig Liver Dis. 2021; 53: 171-182
- Gastroenteropancreatic neuroendocrine tumors: diagnosis and treatment.Ann Gastroenterol. 2013; 26: 29-36
- Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathologic study.Gastroenterology. 1993; 104: 994-1006
- Neuroendocrine neoplasms.Digestive system tumours. who classification of tumours. 5th Edition. IARC Press, Lyon2019 (Volume 1)
- Review article: the investigation and management of gastric neuroendocrine tumours.Aliment Pharmacol Ther. 2014; 39: 1071-1084
- Updated features associated with type 1 gastric carcinoids patients: a single-center study.Scan J Gastroenterol. 2014; 49: 1447-1455
- Review of the pathogenesis, diagnosis, and management of type I gastric carcinoid tumor.World J Surg. 2011; 35: 1879-1886
- Prognostic evaluations tailored to specific gastric neuroendocrine neoplasms: analysis of 200 cases with extended follow-up.Neuroendocrinology. 2018; 107: 114-126
- Narrow band imaging characteristics of gastric polypoid lesions: a single-center prospective pilot study.Eur J Gastroenterol Hepatol. 2020; 32: 701-705
- Tumour type and size are prognostic factors in gastric neuroendocrine neoplasia: a multicentre retrospective study.Dig Liv Dis. 2019; 51: 1456-1460
- Systematic review: gastric cancer incidence in pernicious anaemia.Aliment Pharmacol Ther. 2013; 37: 375-382
- Comparison of endoscopic techniques in the management of type i gastric neuroendocrine neoplasia: a systematic review.Gastroenterol Res Pract. 2021; 20216679397
- Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up.Scand J Gastroenterol. 2015; 50: 856-865
- Type I gastric carcinoids: a prospective study on endoscopic management and recurrence rate.Neuroendocrinology. 2012; 95: 207-213
- Endoscopic surveillance at 3 years after diagnosis, according to European guidelines, seems safe in patients with atrophic gastritis in a low-risk region.Dig Liver Dis. 2021; 53: 467-473
- Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019.Endoscopy. 2019; 51: 365-388https://doi.org/10.1055/a-0859-1883
- Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994.Am J Surg Pathol. 1996; 20: 1161-1181
- Multidisciplinary management of neuroendocrine neoplasia: a real-world experience from a referral center.J. Clin. Med. 2019; 8: 910
- Histopathological classification of nonantral gastric endocrine growths in man.Digestion. 1998; 41: 185-200
- Gastro-entero-pancreatic neuroendocrine neoplasia: the rules for non-operative management.Surg Oncol. 2020; 35: 141-148
- Rate of lymph node metastasis in patients with T1 gastric carcinoid tumors.Eur J Gastroenterol Hepatol. 2021; 32: 302-303
- Metastatic type 1 gastric carcinoid: a real threat or just a myth?.World J Gastroenterol. 2013; 19: 8687-8695
- Selective Resection of Type 1 Gastric Neuroendocrine Neoplasms and the Risk of Progression in an Endoscopic Surveillance Programme.Dig Surg. 2021; 38: 38-45
- Classification, clinicopathologic features and treatment of gastric neuroendocrine tumors.World J Gastroenterol. 2014; 20: 118-125
- Risk factors for disease progression in advanced jejunoileal neuroendocrine tumors.Neuroendocrinology. 2012; 96: 32-40
- Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours.Endocr Relat Canc. 2008; 15: 1083-1097
- Long-term follow-up of a large series of patients with type1 gastric carcinoid tumors: data from a multicenter study.Eur J Endocrinol. 2013; 168: 185-193
- Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study.Endocrine. 2016; 51: 131-139
Article info
Publication history
Published online: December 10, 2021
Accepted:
November 15,
2021
Received:
September 16,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
