Comparison of Endoscopic Techniques in the Management of Type I Gastric Neuroendocrine Neoplasia: A Systematic Review

Panzuto, Francesco; Esposito, Gianluca; Rinzivillo, Maria; Annibale, Bruno

doi:10.1155/2021/6679397

Cited by 19 publications

(15 citation statements)

References 30 publications

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“…Regarding other therapeutic options for GC-1, on the one hand, although endoscopy is the technique of choice for the diagnosis and treatment of GC-1, it does not always achieve margin-free resection, regardless of the endoscopic technique used for tumor removal [ 53 ]. In addition, the endoscopic procedure is not an easy procedure for some patients.…”

Section: Discussionmentioning

confidence: 99%

Chronic Treatment with Somatostatin Analogues in Recurrent Type 1 Gastric Neuroendocrine Tumors

et al. 2023

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Background: Type 1 gastric neuroendocrine tumors (GC-1) represent an uncommon subtype of neoplasms. Endoscopic resection has been proposed as the treatment of choice; active surveillance may be performed in those smaller than 1 cm, while gastric surgery may be performed for those with frequent recurrences. The antiproliferative effect of somatostatin analogues (SSA) is well known, and their action on GC-1s has been postulated as a chronic treatment to reduce recurrence. Methods: A two-centered, retrospective, observational study that included nine patients (55.6% women) diagnosed with GC-1, receiving long-term treatment with SSA, with a median follow-up from baseline of 22 months, was undertaken. Endoscopic follow-up, extension study, and analytical values of chromogranin A (Cg A) and gastrin were collected. Results: In total, 88.9% of patients presented partial or complete response. Treatment with SSA was the only independent factor with a trend to prevent tumor recurrence (Odds Ratio 0.054; p = 0.005). A nonsignificant tendency toward a decrease in CgA and gastrin was observed; lack of significance was probably related to concomitant treatment with proton pump inhibitors in some patients. Conclusions: Chronic treatment with SSA is a feasible option for recurrent GC-1s that are difficult to manage using endoscopy or gastrectomy. Randomized clinical trials to provide more scientific evidence are still needed.

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Section: Discussionmentioning

confidence: 99%

Chronic Treatment with Somatostatin Analogues in Recurrent Type 1 Gastric Neuroendocrine Tumors

et al. 2023

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“…Regarding radical endoscopic removal, it is clear that achieving margin-free resection is advisable in all patients; however, it is not always achieved irrespective of the endoscopic technique used for tumor removal [ 8 ]. Although it is not clear whether residual microscopic tumors may have a direct impact on the disease course, it is reasonable to consider those patients in whom complete resection has not been achieved at higher risk for tumor progression.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the proportion of patients with T1gNEN who develop metastases is <5%, and the long-term overall survival rate is almost 100% [ 3 , 4 , 5 ]. Thus, endoscopic resection is usually considered a curative treatment for these tumors and rarely requires surgery, which needs to be considered when locoregional invasion of the gastric wall or metastatic lymph nodes is present [ 6 , 7 , 8 ]. In smaller lesions < 10 mm, observational endoscopic management may also be advised [ 1 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of 68-Gallium PET in Type I Gastric Neuroendocrine Neoplasia: A Case Series

Rinzivillo

Panzuto

Esposito

et al. 2022

JCM

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Background: Type I gastric neuroendocrine neoplasia (gNEN) is a rare and low-grade tumor in which the therapeutic strategy is almost always endoscopic. For this reason, the use of radiology or nuclear medicine imaging is not recommended by guidelines. Conversely, in a small number of cases, locoregional or distant metastases may develop, thus suggesting a role for imaging techniques. This retrospective study was performed to explore the usefulness of [68Ga]Ga-DOTA-SST PET/CT in the management of patients with T1gNENs. Patients and Method: Single-center retrospective analysis, in an ENETS Center of Excellence, of patients with type I gNEN who underwent [68Ga]Ga-DOTA-SST PET/CT. The indication for performing [68Ga]Ga-DOTA-SST PET/CT was generally based on the presence of at least one of the following criteria: (1) polyps > 10 mm; (2) endoscopic positive (R1) margin after previous endoscopic resection; and (3) Ki-67 > 3%. Results: A total of 120 patients with T1gNEN were evaluated. Overall, 15 out of 120 (13%) patients had performed [68Ga]Ga-DOTA-SST PET/CT. The median Ki-67 value was 6% (IQR 1–9): 9 out of 15 (60%) were G1 tumors, and 6 out of 15 (40%) were G2 tumors. Ninety-three percent of patients were treated by tumor endoscopic resection, whereas surgery was performed in two patients (13%) after incomplete endoscopic resection; the remaining patients (6.6%) received somatostatin analogs due to the presence of multiple recurrent tumors. Overall, [68Ga]Ga-DOTA-SST PET/CT was positive in 8 out of 15 patients (53%). Following the [68Ga]Ga-DOTA-SST PET/CT findings, the clinical management was modified in 6 out of 15 (40%) patients. Conclusion: [68Ga]Ga-DOTA-SST PET/CT can be useful in a restricted and selected group of patients with gastric neuroendocrine neoplasia with relevant risk factors to establish the most appropriate therapeutic strategy.

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“…The management of type 1 neuroendocrine tumors and resection strategy have still not been clarified [162]. The European Neuroendocrine Tumor Society guidelines suggest removing tumors larger than 10 mm as they represent neuroendocrine tumors with potentially more aggressive behavior [163].…”

Section: Supplementation and Clinical Follow-up: Always Be Alertmentioning

confidence: 99%

Pernicious Anemia: The Hematological Presentation of a Multifaceted Disorder Caused by Cobalamin Deficiency

Esposito¹,

Dottori²,

Pivetta³

et al. 2022

Nutrients

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Pernicious anemia is still a neglected disorder in many medical contexts and is underdiagnosed in many patients. Pernicious anemia is linked to but different from autoimmune gastritis. Pernicious anemia occurs in a later stage of autoimmune atrophic gastritis when gastric intrinsic factor deficiency and consequent vitamin B12 deficiency may occur. The multifaceted nature of pernicious anemia is related to the important role of cobalamin, which, when deficient, may lead to several dysfunctions, and thus, the proteiform clinical presentations of pernicious anemia. Indeed, pernicious anemia may lead to potentially serious long-term complications related to micronutrient deficiencies and their consequences and the development of gastric cancer and type 1 gastric neuroendocrine tumors. When not recognized in a timely manner or when pernicious anemia is diagnosed with delay, these complications may be potentially life-threatening and sometimes irreversible. The current review aimed to focus on epidemiology, pathogenesis, and clinical presentations of pernicious anemia in an attempt to look beyond borders of medical specialties. It aimed to focus on micronutrient deficiencies besides the well-known vitamin B12 deficiency, the diagnostic approach for pernicious anemia, its long-term complications and optimal clinical management, and endoscopic surveillance of patients with pernicious anemia.

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Comparison of Endoscopic Techniques in the Management of Type I Gastric Neuroendocrine Neoplasia: A Systematic Review

Cited by 19 publications

References 30 publications

Chronic Treatment with Somatostatin Analogues in Recurrent Type 1 Gastric Neuroendocrine Tumors

Chronic Treatment with Somatostatin Analogues in Recurrent Type 1 Gastric Neuroendocrine Tumors

Usefulness of 68-Gallium PET in Type I Gastric Neuroendocrine Neoplasia: A Case Series

Pernicious Anemia: The Hematological Presentation of a Multifaceted Disorder Caused by Cobalamin Deficiency

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