Early diagnosis and treatment of gastrointestinal neuroendocrine tumors

Abstract

Abstract. The aim of the present retrospective analysis on the macroscopic appearance and pathological characteristics of gastrointestinal neuroendocrine tumors (NETs) was to investigate methods for their early diagnosis and treatment. A total of 78 patients were divided into submucosal NET and deeper invasion NET groups, according to the depth of tumor invasion exhibited by the patients. The clinicopathological characteristics and survival time of the NET patients were analyzed and compared. The pathological characteristics of the submucosal NETs group were investigated according to the diameter of the tumor (≤5.0 mm, 5.1-10.0 mm or >10.0 mm). The depth of invasion at diagnosis was observed to significantly correlate with histopathological classification, diameter of the tumor, macroscopic appearance, growth pattern, lymphatic-vascular involvement, lymph node (LN) metastasis and distant metastasis. In the submucosal NETs group, high-grade tumors with lymphatic or venule invasion and distant metastasis were associated with an increased risk of nodal metastases. In patients with minute tumors (≤5.0 mm), no lymphatic-vascular involvement, LN or distant metastasis was observed. By contrast, patients with tumors measuring 5.1-10.0 mm in diameter exhibited high lymphatic-vascular involvement and LN metastasis rates (46.2 and 30.8%, respectively). Survival time was significantly longer in patients with submucosal NETs compared with deeper invasion NETs and in patients with NET G1 and NET G2 compared with NEC. The results of the present study indicate that gastrointestinal submucosal NETs are closely associated with a slightly elevated macroscopic type, low-grade tumors and a small diameter. These features may contribute to early diagnosis of gastrointestinal NETs. Therefore, a tumor diameter of <5.0 mm, with slightly elevated macroscopic appearance may indicate an absolute requirement for endoscopic resection, while tumors measuring 5.1-10.0 mm in diameter must be considered carefully.

Surgical Strategy Based on Radiological 3D Reconstruction in a Giant Metastatic Neuroendocrine Tumor of the Pancreas: A Case Report of an Interdisciplinary Approach

“…Neuroendocrine tumors (NETs) are rare tumors with a relative incidence of 2% of all neoplasms and are most commonly found in the gastroenteropancreatic tract [ 1 ]. The absolute incidence of these rare neoplasms has increased in recent years.…”

“…The absolute incidence of these rare neoplasms has increased in recent years. This is mainly due to the improved diagnostics and increasing knowledge about these tumors [ 1 , 2 ]. The clinical outcome of patients with NETs depends on several factors, such as location and resectability of the tumor, Ki67 expression, which determines grading, and finally staging [ 3 – 5 ].…”

Gangliocytic paraganglioma: An overview and future perspective

“…Gastrointestinal neuroendocrine tumors (NETs) have a low, but gradually increasing, incidence worldwide[1]. Specifically, the overall prognosis for patients with gastrointestinal NETs has improved and has been favorable[2], but some investigators have reported 5-year survival rates of patients with NET G1 of approximately 80%[3]. Although few patients with liver metastases[4-7] and one with fatal GP[6] have been reported, GP shows a benign course more frequently than NET G1.…”

Incidence of Neuroendocrine Tumors in the United States from 2001-2015: A United States Cancer Statistics Analysis of 50 States

“…Neuroendocrine tumors (NETs), once considered a rare malignancy, have started to become a more prevalent cancer in the United States (US) [1]. The most common location of NETs is in the gastrointestinal (GI) system [1-3]. In the US, the incidence is increasing, with a seven-fold increase over the past 35 years [1].…”

“…The most common location of NETs is in the gastrointestinal (GI) system [1-3]. In the US, the incidence is increasing, with a seven-fold increase over the past 35 years [1]. Prior studies that have evaluated the incidence of NETs have used the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) program.…”