Endoscopic resection for duodenal carcinoid tumors: A multicenter, retrospective study

Abstract

Endoscopic resection appears to be a safe and effective treatment for duodenal carcinoid tumors measuring ≤ 10 mm in diameter and confined to the submucosal layer.

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

“…Corresponding results were also reported in the previous studies of D-NET [5,19,22]. In addition, only 4 cases had functional or hormonal syndrome (ZES with gastrin excessive), which is also similar to previous reports; 50-98% of D-NETs present no functional syndrome despite the positive immunoreactivity for gastrin, somatostatin, and/or serotonin in majority of D-NETs [5].…”

“…In addition to ENETS's recommendation of ER for NAD-NETs <10 mm in diameter, Burke et al [10] reported that there were no metastases identified in D-NETs <10 mm. Kim et al [22 ]also reported that 33 patients with D-NETs measuring ≤10 mm in diameter and confined to the submucosa demonstrated no recurrence following ER providing the absence of metastasis revealed by CT at the time of procedure. However, other studies did report metastasis in such tumors [11,19].…”

“…Moreover, when LN dissection is not required, it is also unclear which of the following the best therapeutic approach is: local resection in surgery, EMR, or ESD. Based on the result of previous studies [22,27] and the present study, it is difficult to achieve R0 resection by EMR in all cases. Meanwhile, ESD has a higher complication risk [28], and open surgery has a potential of higher morbidity and mortality [29].…”

ENETS Consensus Guidelines Update for Gastroduodenal Neuroendocrine Neoplasms

“…Therefore, the minimal approach should be to resect tumors ≥10 mm. Resection should be performed by experienced endoscopists in gastric tumors using either EMR or endoscopic submucosal dissection (ESD); the latter has the benefit of an en bloc resection for complete histological appraisal and has been shown effective in a total of 96 patients [21,22,23,24]. Nonetheless, EMR and ESD do carry risks of bleeding and perforation.…”

Endoscopic mucosal resection of duodenal bulb adenocarcinoma with neuroendocrine features: An extremely rare case report

“…Malignant NET, such as type 3 gastric NETs which are considered to be aggressive and often with metastasis, can also be treated successfully by endoscopic treatment, including EMR [10] . Endoscopic resection appears to be a safe and effective treatment for duodenal carcinoid tumors measuring ≤ 10 mm in diameter and confined to the submucosal layer [11] .…”