Clinical Outcomes for Neuroendocrine Tumors of the Duodenum and Ampulla of Vater:A Population-Based Study

Randle, Reese W.; Ahmed, Shuja; Newman, Naeem A.; Clark, Clancy J.

doi:10.1007/s11605-013-2365-4

Cited by 84 publications

(46 citation statements)

References 21 publications

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“…Although CD31 is reported to be useful for the evaluation of venous invasion [34,35], we evaluated E-M staining instead of CD31 in this study. Some studies examined D-NET based on a large registry database [11,36], but it is difficult to evaluate the detailed histopathological findings in these studies which did not perform central review of histopathological findings which is an absolute key to understand the true nature of the neoplasms. Third, all the included NAD-NETs in our present study were ≤20 mm in diameter.…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

et al. 2017

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Background/Aims: The treatment strategy for non-ampullary duodenal neuroendocrine tumors (NAD-NETs) ≤20 mm in diameter has not been established. In this study, we aimed to evaluate the detailed characteristics of NAD-NETs ≤20 mm in diameter to clarify the risk factors of subsequent metastasis. Methods: The patients with NAD-NETs ≤20 mm in diameter who had been treated at 12 institutions between 1992 and 2013 were enrolled. Clinical records were retrieved, and histopathological findings of all cases were centrally reviewed by 2 pathologists. Results: We studied 49 patients with a mean follow-up period of 66.5 months. Thirty-five patients were initially treated with endoscopic resection (ER), and 14 with surgery. A univariate analysis revealed the ORs and 95% CIs of the risk factors for metastasis were lymphovascular invasion (12.5 [2.01-77.9]), multiple tumors (9.75 [1.46-65.4]), a tumor size of 11-20 mm (6.67 [1.21-36.6]), and World Health Organization grade G2 (7.13 [1.16-43.9]). Five-year overall and disease-specific survival rates were 86.1 and 97.2%, respectively. Conclusion: This is the first study to demonstrate the risk factors of metastasis in NAD-NETs ≤20 mm in diameter. These findings may be helpful for determining the appropriate therapeutic approach and the clinical strategy of treatment following ER.

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Section: Discussionmentioning

confidence: 99%

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

et al. 2017

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“…The procedure of LR was defined as simple resection or partial removal of lesion by polypectomy, excisional biopsy and excision of lesions. RR was defined as debulking or radical resection with an en bloc resection (partial or total removal) [41]. Further clinical studies are required to validate the favorable effect of LR as well as the precise extent of surgical resection.…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: a population based retrospective study

Wan

et al. 2016

Oncotarget

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BackgroundSmall intestinal neuroendocrine tumors (SiNETs) without distant metastasis typically behave in an indolent manner, but there can be heterogeneity. We aimed to define the survival outcomes and impacts of surgical intervention.MethodsA retrospective cohort study was conducted by using data from the Surveillance, Epidemiology, and End Results (SEER) database. Clinicopathologic features were analyzed in 4407 patients between 2000 and 2012. The cancer specific survival (CSS) was calculated by the Kaplan-Meier method. Multivariable Cox regression models with hazard ratios (HRs) were constructed to analyze survival outcomes and risk factors.ResultsThe adjusted incidence of early SiNETs is 1.3/100,000. Tumors are most commonly located in the ileum and are small (≤ 2 cm). The 5-year and 10-year CSS rates were 95.0% and 88.5%, respectively. Age > 50 years, large tumor size (> 2cm), poor differentiation, advanced T classification, and absence of surgical treatment were independent predictors of poor survival. Stratified analysis indicated that surgery significantly improved survival in patients that were white (HR, 0.45), > 50 years old (HR, 0.61), had duodenal tumors (HR, 0.43), large tumors (> 2cm) (HR, 0.32), advanced T classification (T3: HR, 0.29; T4: HR, 0.18) or well differentiation (HR, 0.55). There was no significant survival difference between local resection and radical resection (P =0.884).ConclusionsEarly SiNETs have a favorable prognosis. Surgical resection may improve outcomes, particularly in older patients and those with large tumors. More aggressive resections couldn't improve outcomes.

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“…A recent SEER analysis identified 1,360 duodenal NETs between 1988 and 2009, with 787 undergoing resection. Of these, only 25% had any lymph nodes removed, and the median primary tumor size was 1.0cm(2). In our cohort, patients underwent more extensive surgery with 78% having lymph nodes removed, and had larger tumors, with all but 1 primary tumor larger than 1.2cm.…”

Section: Discussionmentioning

confidence: 99%

“…Duodenal neuroendocrine tumors constitute one of the rarest types of neuroendocrine tumors (NETs), with an annual incidence of 0.19 per 100,000 in the United States, representing approximately 4% of all NETs(1, 2). Gastric neuroendocrine tumors have an incidence of 0.30 per 100,000, and their numbers have increased dramatically over time due to the proliferation of upper endoscopy and possibly the use of acid suppressive medications(1, 3, 4).…”

Section: Introductionmentioning

confidence: 99%

GIPR expression in gastric and duodenal neuroendocrine tumors

Sherman

Maxwell

Carr

et al. 2014

Journal of Surgical Research

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Background Compounds targeting somatostatin-receptor-type-2 (SSTR2) are useful for small bowel (SBNET) and pancreatic neuroendocrine tumor (PNET) imaging and treatment. We recently characterized expression of 13 cell-surface receptor genes in SBNETs and PNETs, identifying three drug targets (GIPR, OXTR, and OPRK1). This study set out to characterize expression of this gene panel in the less-common neuroendocrine tumors of the stomach and duodenum (GDNETs). Methods Primary tumors and adjacent normal tissue were collected at surgery, RNA was extracted, and expression of 13 target genes was determined by quantitative-PCR. Expression was normalized to GAPDH and POLR2A internal control genes. Expression relative to normal tissue (ddCT) and absolute expression (dCT) were calculated. Wilcoxon tests compared median expression with false discovery rate correction for multiple comparisons. Results Gene expression was similar in 2 gastric and 7 duodenal tumors, and these were analyzed together. Like SBNETs (n=63) and PNETs (n=51), GDNETs showed significant overexpression compared to normal tissue of BRS3, GIPR, GRM1, GPR113, OPRK1, and SSTR2 (p<0.05 for all). Of these, SSTR2 had the highest absolute expression in GDNETs (median dCT 4.0). Absolute expression of BRS3, GRM1, GPR113, and OPRK1 was significantly lower than SSTR2 in GDNETs (p<0.05 for all), while expression of GIPR was similar to SSTR2 (median 4.3, p=0.4). Conclusions As in SBNETs and PNETs, GIPR shows absolute expression close to SSTR2, but has greater overexpression relative to normal tissue (21.1 vs. 3.5-fold overexpression). We conclude that GIPR could provide an improved signal-to-noise ratio for imaging versus SSTR2, and represents a promising novel therapeutic target in GDNETs.

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Clinical Outcomes for Neuroendocrine Tumors of the Duodenum and Ampulla of Vater:A Population-Based Study

Abstract: While ampullary NETs are more advanced at presentation and have worse OS than duodenal NETs, long-term survival is possible with proximal small bowel NETs. For locally resected NETs, OS is similar between ampullary and duodenal NETs.

Cited by 84 publications

References 21 publications

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: a population based retrospective study

GIPR expression in gastric and duodenal neuroendocrine tumors

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